| NPI | 1083843544 |
|---|---|
| Former Name | NAN ELIZABETH MONROE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: AR 4160) |
| Additional Taxonomies | 122300000X Dentist (Licence: MS 3580-11) |
| Enumeration Date | 2009-07-06 |
| Last Update Date | 2018-01-11 |