| NPI | 1124013867 |
|---|---|
| Former Name | ELLEN FRANCES OKONIEWSKI |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223D0001X Dentist, Dental Public Health (Licence: KS 60532) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019-025884) |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2013-03-29 |