| NPI | 1912664210 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: CA 924) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: CA 33867) |
| Enumeration Date | 2021-11-21 |
| Last Update Date | 2022-08-11 |