NPI | 1417240078 |
---|---|
Former Name | JENNIFER SUSAN ANDREYKA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: AZ D0081040) |
Additional Taxonomies | 122300000X Dentist (Licence: CA 60283) |
Enumeration Date | 2011-05-16 |
Last Update Date | 2011-05-16 |