| NPI | 1679817340 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: PA DH071112) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: PA DHA001219) |
| Enumeration Date | 2012-11-20 |
| Last Update Date | 2012-11-20 |