| NPI | 1629305081 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: MN H8428) |
| Additional Taxonomies | 126800000X Dental Assistant (Licence: MN A12416) |
| Enumeration Date | 2009-11-05 |
| Last Update Date | 2009-11-05 |