NPI | 1174185805 |
---|---|
Former Name | ANNIE ERNST |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: MO 2019019579) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MO 2019019579) |
Enumeration Date | 2019-07-02 |
Last Update Date | 2022-09-12 |