| NPI | 1265059240 |
|---|---|
| Former Name | AMY MAYSE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN 1265059240) |
| Additional Taxonomies | 122300000X Dentist (Licence: IA DDS-09781) |
| 1223G0001X Dentist, General Practice (Licence: MN D14523) | |
| Enumeration Date | 2020-06-25 |
| Last Update Date | 2024-01-18 |