NPI | 1376307249 |
---|---|
Former Name | RACHEL MARIE JOHNSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: CA 532) |
Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: CA 23414) |
Enumeration Date | 2024-02-09 |
Last Update Date | 2024-02-09 |