Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | 4588 | MD |
NPI | 1053525774 |
---|---|
Provider Name | Ms. Galina Livchits |
First Address | Rockville, MD 20852 |
Second Address | Rockville, MD 20852-1658 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2007 |
Last Update Date | 08/07/2007 |