NPI | 1801214614 |
---|---|
Former Name | MICHELL HUDDLESTON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: OK 2761) |
Additional Taxonomies | 124Q00000X Dental Hygienist |
Enumeration Date | 2014-03-31 |
Last Update Date | 2014-04-01 |