| NPI | 1154509677 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: CA 16999) |
| Additional Taxonomies | 126900000X Dental Laboratory Technician (Licence: CA 16999) |
| Enumeration Date | 2008-02-06 |
| Last Update Date | 2008-02-06 |