| NPI | 1588004576 |
|---|---|
| Former Name | MADELINE LEAH HOEG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 63889) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2013-07-05 |
| Last Update Date | 2014-12-11 |