NPI | 1497140719 |
---|---|
Former Name | CHELSEA ELIZABETH MITCHELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: GA DN015821) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2015-04-02 |
Last Update Date | 2020-07-28 |