NPI | 1225662687 |
---|---|
Former Name | ASHLEY RAYE ROTH-GARCIA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ D010836) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2020-02-25 |
Last Update Date | 2021-09-22 |