Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | 9382146-9920 | UT |
NPI | 1013439181 |
---|---|
Provider Name | Cheryl L Ramirez |
First Address | Apo, AE 09112-0055 |
Second Address | Apo, AE 09112 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2017 |
Last Update Date | 20/07/2017 |