| NPI | 1417258260 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: PA DH068878) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: PA PHDH000121) |
| 124Q00000X Dental Hygienist (Licence: NY 024762-1) | |
| Enumeration Date | 2010-11-10 |
| Last Update Date | 2010-11-10 |