NPI | 1437392701 |
---|---|
Former Name | AIME BROYLES-MAYUGA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MO 2007037234) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: KS 6970) |
Enumeration Date | 2009-04-15 |
Last Update Date | 2011-07-07 |