| NPI | 1508115817 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: WI 1003719) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA 703436) |
| Enumeration Date | 2012-08-31 |
| Last Update Date | 2020-09-17 |