NPI | 1235584913 |
---|---|
Former Name | TEMICKA TERRELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TN DS0000010434) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2016-04-29 |
Last Update Date | 2022-01-13 |