| NPI | 1730762030 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 125K00000X Advanced Practice Dental Therapist (Licence: CA 867) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: CA 33195) |
| Enumeration Date | 2021-05-04 |
| Last Update Date | 2022-09-06 |