| NPI | 1760991582 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: ME RDH3652) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: NH 02884) |
| Enumeration Date | 2017-09-25 |
| Last Update Date | 2017-09-25 |