NPI | 1669100277 |
---|---|
Former Name | TAYLOR CAIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: MO 2022029427) |
Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: IL 020016318) |
Enumeration Date | 2022-08-11 |
Last Update Date | 2023-10-19 |