| NPI | 1881826931 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 125K00000X Advanced Practice Dental Therapist (Licence: CA 103342) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 103342) |
| Enumeration Date | 2009-08-21 |
| Last Update Date | 2024-10-22 |