| NPI | 1497757801 |
|---|---|
| Former Name | MICHELLE L. CHRISTENSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR D7923) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: OR D7923) |
| Enumeration Date | 2005-08-15 |
| Last Update Date | 2019-03-27 |