NPI | 1225342314 |
---|---|
Former Name | RAELENE FRANCES MCDOWALL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: CO DEN.00202002) |
Additional Taxonomies | 122300000X Dentist (Licence: CA 56263) |
Enumeration Date | 2010-07-30 |
Last Update Date | 2017-04-24 |