NPI | 1013229541 |
---|---|
Former Name | LIBERTY FRANKLIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: WA DE60156043) |
Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: WA DE60156043) |
Enumeration Date | 2010-07-13 |
Last Update Date | 2023-08-07 |