| NPI | 1972003168 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: PA DH004957L) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: PA PHDH000159) |
| Enumeration Date | 2018-02-14 |
| Last Update Date | 2018-02-14 |