| NPI | 1699218792 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: NY 51 024640) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: NJ 22HI00940500) |
| Enumeration Date | 2016-11-22 |
| Last Update Date | 2016-11-22 |