| NPI | 1902395403 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: FL 28117) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: NJ 22HI01034900) |
| Enumeration Date | 2018-05-09 |
| Last Update Date | 2021-12-17 |