| NPI | 1275991143 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: WA DH5238) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: CA 26601) |
| Enumeration Date | 2016-02-05 |
| Last Update Date | 2016-02-05 |