| NPI | 1558912121 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 126800000X Dental Assistant (Licence: OR 000567) |
| Additional Taxonomies | 126800000X Dental Assistant (Licence: WA D160263613) |
| Enumeration Date | 2019-09-25 |
| Last Update Date | 2021-09-21 |