| NPI | 1740742311 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: NJ 22HI01107400) |
| Additional Taxonomies | 126800000X Dental Assistant |
| Enumeration Date | 2019-04-03 |
| Last Update Date | 2019-04-03 |