| NPI | 1457179921 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 126800000X Dental Assistant (Licence: OR 1128845) |
| Additional Taxonomies | 126800000X Dental Assistant (Licence: WA D160914067) |
| Enumeration Date | 2024-10-02 |
| Last Update Date | 2025-06-03 |