| NPI | 1609104488 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: PA PHDH000415) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: PA DH070118) |
| Enumeration Date | 2009-12-06 |
| Last Update Date | 2020-02-12 |