NPI | 1992051098 |
---|---|
Former Name | MICHELLE LYNNE FELLINGER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 126800000X Dental Assistant (Licence: CA rda63963) |
Additional Taxonomies | 126800000X Dental Assistant (Licence: CA 63963) |
Enumeration Date | 2012-07-26 |
Last Update Date | 2012-07-26 |