| NPI | 1639680408 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: PA PHDH000312) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: PA DH010018L) |
| Enumeration Date | 2017-10-19 |
| Last Update Date | 2017-10-19 |