NPI | 1366602013 |
---|---|
Former Name | KYLE MICHELE PLATSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: TX 27224) |
Additional Taxonomies | 122300000X Dentist (Licence: IL 019027645) |
Enumeration Date | 2008-06-16 |
Last Update Date | 2018-11-30 |