| NPI | 1518310770 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 126800000X Dental Assistant (Licence: OR A30798) |
| Additional Taxonomies | 126800000X Dental Assistant (Licence: WA D160037866) |
| 126800000X Dental Assistant (Licence: OR A30524) | |
| Enumeration Date | 2016-07-22 |
| Last Update Date | 2020-06-23 |