NPI | 1073804670 |
---|---|
Former Name | SUZETTA NASH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: OK 6674) |
Additional Taxonomies | 122300000X Dentist (Licence: NY 056112-1) |
122300000X Dentist (Licence: TX 30531) | |
Enumeration Date | 2011-04-29 |
Last Update Date | 2015-02-17 |