| NPI | 1083876767 |
|---|---|
| Former Name | KYRA A. TOULOUSE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MN D12519) |
| Additional Taxonomies | 122300000X Dentist (Licence: WI 6260) |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2012-05-29 |