NPI | 1225144256 |
---|---|
Former Name | RENATA L LICHTY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: KS KS60689) |
Additional Taxonomies | 122300000X Dentist (Licence: CO 9879) |
1223G0001X Dentist, General Practice (Licence: OH 30-022383) | |
Enumeration Date | 2006-08-22 |
Last Update Date | 2022-11-23 |