NPI | 1083934046 |
---|---|
Former Name | DINA PICKLE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: WA DH00006726) |
Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: KS 2665) |
Enumeration Date | 2010-06-01 |
Last Update Date | 2010-06-01 |