| NPI | 1780879593 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: MA DH3760) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: MA 3760) |
| Enumeration Date | 2007-09-14 |
| Last Update Date | 2011-12-21 |