| NPI | 1720774938 |
|---|---|
| Other Name | PRESTIGE AESTHETICS AND HYDRATION LOUNGE |
| Entity Type | Organization |
| Authorized Contact | DIESAWIT T HANSOM Fnp 720-343-9799 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2023-04-12 |
| Last Update Date | 2023-06-12 |