| NPI | 1588052377 |
|---|---|
| Former Name | JODY ELLEN MILBERT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: WI 5739-16) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: MN H2738) |
| Enumeration Date | 2014-12-31 |
| Last Update Date | 2014-12-31 |