NPI | 1144328220 |
---|---|
Former Name | CYNTHIA MARIE MALECKI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: TX 29652) |
Additional Taxonomies | 122300000X Dentist (Licence: AK AK1051) |
Enumeration Date | 2006-09-20 |
Last Update Date | 2015-03-23 |