NPI | 1093156002 |
---|---|
Former Name | ALISA S. HENKLE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: CO 903692) |
Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: KS 10216) |
124Q00000X Dental Hygienist (Licence: NE 1454) | |
Enumeration Date | 2013-07-08 |
Last Update Date | 2013-07-08 |