| NPI | 1407191117 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 125J00000X Dental Therapist (Licence: CA 25029) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA 25029) |
| Enumeration Date | 2012-12-06 |
| Last Update Date | 2012-12-06 |