NPI | 1629578893 |
---|---|
Former Name | JENNIFER KWAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: CO DH.002025002) |
Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: CO LOCAL.0001364) |
Enumeration Date | 2018-02-14 |
Last Update Date | 2018-02-14 |