| NPI | 1013272749 |
|---|---|
| Former Name | KATIE BREEZE BERKELHAMMER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN20304) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL 1052) |
| 122300000X Dentist (Licence: NC 9424) | |
| Enumeration Date | 2012-07-09 |
| Last Update Date | 2015-04-02 |