| NPI | 1982097556 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: NH 02871) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: MA DH87311) |
| Enumeration Date | 2015-03-06 |
| Last Update Date | 2015-03-06 |