| NPI | 1982949830 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 126800000X Dental Assistant (Licence: WA D160030008) |
| Additional Taxonomies | 126800000X Dental Assistant (Licence: OR A2470) |
| Enumeration Date | 2012-12-04 |
| Last Update Date | 2012-12-04 |