| 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 |