NPI | 1144632555 |
---|---|
Former Name | NATALIE ELIZABETH CROOKS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: MN D13354) |
Additional Taxonomies | 122300000X Dentist (Licence: IA DDS-09009) |
Enumeration Date | 2014-05-20 |
Last Update Date | 2014-05-20 |