NPI | 1467977215 |
---|---|
Former Name | GEORGE ANTHONY BOOKER |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225700000X Massage Therapist (Licence: WA MA60802924) |
Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: MT 1282) |
124Q00000X Dental Hygienist (Licence: WA DH60284757) | |
126800000X Dental Assistant (Licence: WA D160057846) | |
Enumeration Date | 2017-08-12 |
Last Update Date | 2019-04-25 |