| NPI | 1992241376 |
|---|---|
| Former Name | DIANE RIVERA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: CA HAP604) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: CA RDH13827) |
| Enumeration Date | 2017-01-10 |
| Last Update Date | 2017-01-10 |