| NPI | 1598177271 |
|---|---|
| Former Name | MACKENSIE JANE TAPPE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: MN D13436) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2014-05-28 |
| Last Update Date | 2018-10-30 |