Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 124Q00000X | Dental Hygienist |
NPI | 1073193199 |
---|---|
Provider Name | Jodi Murray |
First Address | Eugene, OR 97401-7448 |
Second Address | Eugene, OR 97401-7448 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2021 |
Last Update Date | 12/04/2021 |