| NPI | 1255015327 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: CO DH002026712) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: GA DH044551) |
| 124Q00000X Dental Hygienist (Licence: FL DH29221) | |
| Enumeration Date | 2023-06-09 |
| Last Update Date | 2024-02-03 |