| NPI | 1245383793 |
|---|---|
| Former Name | GEORGETTE BRAGAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: DE G1-0001094) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: DE 1094) |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2019-08-26 |