| NPI | 1174963904 |
|---|---|
| Former Name | ERICA ANN STUTIUS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: VA 0401415316) |
| Additional Taxonomies | 1223P0221X Dentist Pediatric Dentistry (Licence: NC 10132) |
| 1223P0221X Dentist Pediatric Dentistry (Licence: MA DN1856846) | |
| Enumeration Date | 2013-06-25 |
| Last Update Date | 2016-09-30 |