NPI | 1255084166 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 125J00000X Dental Therapist (Licence: MN DT145) |
Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: MN H11217) |
Enumeration Date | 2022-01-31 |
Last Update Date | 2022-06-28 |