| NPI | 1366709768 |
|---|---|
| Former Name | JILL MARIE JACOBSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: AK 2027) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: WA DH 60100153) |
| Enumeration Date | 2012-04-23 |
| Last Update Date | 2012-04-23 |