| NPI | 1790028678 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: ME RDH2727) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: ME IPH58) |
| Enumeration Date | 2013-03-29 |
| Last Update Date | 2017-01-26 |