| NPI | 1649368390 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: PA DH011782L) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: FL DH 11759) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2007-07-08 |