NPI | 1043410152 |
---|---|
Former Name | TAMMIE K NEAL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: VA 0401008679) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VA 0401008679) |
Enumeration Date | 2007-07-18 |
Last Update Date | 2014-07-21 |