| NPI | 1710249081 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: CA 25154) |
| Additional Taxonomies | 126800000X Dental Assistant (Licence: CA 70473) |
| Enumeration Date | 2012-06-13 |
| Last Update Date | 2012-06-13 |