| NPI | 1164073904 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 125J00000X Dental Therapist (Licence: OR DT0010) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: OR H7180) |
| Enumeration Date | 2019-09-24 |
| Last Update Date | 2023-08-18 |