NPI | 1023472347 |
---|---|
Former Name | LAURA CHRISTINE MARTIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OH 30.24786) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2016-04-12 |
Last Update Date | 2022-07-21 |