| NPI | 1619237989 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 126800000X Dental Assistant (Licence: OR A30704) |
| Additional Taxonomies | 126800000X Dental Assistant (Licence: WA 60267199) |
| Enumeration Date | 2012-05-21 |
| Last Update Date | 2012-05-21 |