| NPI | 1417348053 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: NH 02448) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: ME 2621) |
| Enumeration Date | 2015-02-17 |
| Last Update Date | 2015-02-17 |