NPI | 1114366226 |
---|---|
Former Name | JENNIFER J HASKINS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: WI 10908106) |
Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: VA 0402203674) |
Enumeration Date | 2013-06-21 |
Last Update Date | 2013-06-21 |