| NPI | 1417485954 |
|---|---|
| Former Name | DESSEREE MARIE LYSNE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: AZ D009736) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: AZ D009736) |
| Enumeration Date | 2017-05-29 |
| Last Update Date | 2025-02-25 |