| NPI | 1609242676 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 125K00000X Advanced Practice Dental Therapist (Licence: CA 572) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: AK 1006) |
| 124Q00000X Dental Hygienist (Licence: CA rdh17970) | |
| Enumeration Date | 2015-08-13 |
| Last Update Date | 2015-08-13 |