| NPI | 1821260274 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: CT 004591) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: MA 8623) |
| Enumeration Date | 2008-03-26 |
| Last Update Date | 2008-03-26 |