| NPI | 1174059604 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: WA DH00001697) |
| Additional Taxonomies | 126800000X Dental Assistant (Licence: WA D2 60156655) |
| Enumeration Date | 2017-05-03 |
| Last Update Date | 2017-05-03 |