| NPI | 1528397734 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: MN H5240) |
| Additional Taxonomies | 125K00000X Advanced Practice Dental Therapist (Licence: MN DT35) |
| Enumeration Date | 2009-12-17 |
| Last Update Date | 2017-11-15 |