| NPI | 1144551003 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 126800000X Dental Assistant (Licence: WA D160049121) |
| Enumeration Date | 2010-01-15 |
| Last Update Date | 2010-01-15 |