Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | 33730 | CA |
NPI | 1013518091 |
---|---|
Provider Name | Marylu Guzman |
First Address | Hanford, CA 93230-6940 |
Second Address | Lindsay, CA 93247-1448 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/11/2020 |
Last Update Date | 05/11/2020 |