| NPI | 1558687350 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: VA 0402204349) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: MA DH87235) |
| Enumeration Date | 2010-04-19 |
| Last Update Date | 2010-04-19 |