| NPI | 1740408525 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: OR H3649) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: NY 0124001) |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2007-07-08 |