| NPI | 1700244167 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: CO DH000905293) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: FL DH22195) |
| Enumeration Date | 2016-02-01 |
| Last Update Date | 2016-02-01 |