| NPI | 1942544325 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: MA DH9993) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: RI DH01410) |
| Enumeration Date | 2012-11-25 |
| Last Update Date | 2012-11-25 |