NPI | 1326353673 |
---|---|
Former Name | SAMANTHA A. MANIERRE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA DE60477203) |
Additional Taxonomies | 122300000X Dentist (Licence: WA DE60477203) |
Enumeration Date | 2010-08-11 |
Last Update Date | 2023-01-10 |