NPI | 1538608013 |
---|---|
Former Name | TIFFANY DENISE CHOAT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: GA DH012401) |
Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: TX 20420) |
Enumeration Date | 2017-02-17 |
Last Update Date | 2017-02-17 |