| NPI | 1376720581 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: CA RDH22749) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: MO 2009024711) |
| Enumeration Date | 2008-01-30 |
| Last Update Date | 2011-06-20 |