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 |