| NPI | 1215325162 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: CO 2023390) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: CO CO2023390) |
| Enumeration Date | 2014-12-30 |
| Last Update Date | 2020-07-01 |