| NPI | 1124423959 |
|---|---|
| Former Name | KAYLA BATEMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NV s3-309) |
| Additional Taxonomies | 122300000X Dentist (Licence: NV 6550) |
| Enumeration Date | 2014-10-22 |
| Last Update Date | 2018-08-23 |