| NPI | 1558850180 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: NY 029135) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: NJ 22HI01085900) |
| Enumeration Date | 2018-05-09 |
| Last Update Date | 2018-05-09 |