| NPI | 1003154808 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: CA 455) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: CA 24861) |
| Enumeration Date | 2013-01-29 |
| Last Update Date | 2018-09-24 |