| NPI | 1710398649 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: CA 21590) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: CA HAP 496) |
| Enumeration Date | 2014-05-14 |
| Last Update Date | 2014-05-14 |