NPI | 1043280183 |
---|---|
Former Name | STEPHANIE NMI CALHOUN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: GA 011651) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: GA 011651) |
Enumeration Date | 2006-01-23 |
Last Update Date | 2023-03-08 |