NPI | 1225755101 |
---|---|
Former Name | DUSTINE ODLE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208600000X Surgery (Licence: WA 61337407) |
Additional Taxonomies | 208600000X Surgery (Licence: CA 22720) |
208600000X Surgery (Licence: NV 1617A) | |
208600000X Surgery (Licence: TX 15868) | |
208600000X Surgery (Licence: AZ 8161) | |
Enumeration Date | 2022-10-21 |
Last Update Date | 2022-10-21 |