| NPI | 1104313576 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: CO DH000905723) |
| Additional Taxonomies | 124Q00000X Dental Hygienist |
| Enumeration Date | 2018-04-20 |
| Last Update Date | 2018-04-20 |