NPI | 1497749865 |
---|---|
Former Name | MARGARET ELLEN POLIFKO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: VA 0401411056) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VA 0401411056) |
Enumeration Date | 2005-08-31 |
Last Update Date | 2022-06-09 |