NPI | 1205223732 |
---|---|
Former Name | JENNIFER BIRD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: MN H7818) |
Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: WI 10350) |
Enumeration Date | 2015-04-22 |
Last Update Date | 2024-01-30 |