NPI | 1053548511 |
---|---|
Former Name | BRENDA KRISTINE LENSER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: WI 6408-15) |
Additional Taxonomies | 122300000X Dentist (Licence: CO 10160) |
Enumeration Date | 2009-06-11 |
Last Update Date | 2024-05-21 |