NPI | 1427247402 |
---|---|
Former Name | KATHERINE LYNN FRY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: GA 13702) |
Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: AL 5473) |
Enumeration Date | 2007-10-16 |
Last Update Date | 2022-08-16 |