| NPI | 1669716114 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: PA DHO71027) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: PA DHA001150) |
| Enumeration Date | 2012-11-23 |
| Last Update Date | 2012-11-23 |