| NPI | 1790310050 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: CA 774) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: CA 22854) |
| Enumeration Date | 2020-03-06 |
| Last Update Date | 2020-03-06 |