| NPI | 1215604988 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 125J00000X Dental Therapist (Licence: ME RDH4471) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: ME RDH4471) |
| 124Q00000X Dental Hygienist (Licence: MN H11055) | |
| 125J00000X Dental Therapist (Licence: MN DT142) | |
| Enumeration Date | 2021-08-30 |
| Last Update Date | 2025-05-13 |