| NPI | 1245894740 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: MN H7601) |
| Additional Taxonomies | 126800000X Dental Assistant (Licence: MN A9581) |
| Enumeration Date | 2019-04-30 |
| Last Update Date | 2019-04-30 |