| NPI | 1083970750 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 125K00000X Advanced Practice Dental Therapist (Licence: MN DT7) |
| Additional Taxonomies | 125J00000X Dental Therapist (Licence: MN DT7) |
| Enumeration Date | 2012-04-07 |
| Last Update Date | 2017-02-14 |