| NPI | 1164095485 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 292200000X Dental Laboratory (Licence: CA RHP00089307) |
| Additional Taxonomies | 126900000X Dental Laboratory Technician (Licence: CA RHP00089307) |
| Enumeration Date | 2021-07-23 |
| Last Update Date | 2021-07-23 |