| NPI | 1003222753 |
|---|---|
| Former Name | JANETTE PATRICE WAHL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 35583) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 35583) |
| Enumeration Date | 2014-07-02 |
| Last Update Date | 2014-07-02 |