NPI | 1164229605 |
---|---|
Former Name | KATHERINE MACLELLAN GOTHARD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: PA DS044996) |
Additional Taxonomies | 122300000X Dentist (Licence: GA DN123173) |
Enumeration Date | 2025-03-03 |
Last Update Date | 2025-03-03 |