| NPI | 1700109790 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: CT 006256) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: MA 12417) |
| Enumeration Date | 2010-03-05 |
| Last Update Date | 2010-03-05 |