| NPI | 1154803526 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: CO 002025015) |
| Additional Taxonomies | 122300000X Dentist (Licence: CO 2025015) |
| Enumeration Date | 2018-09-03 |
| Last Update Date | 2024-06-12 |