NPI | 1508153198 |
---|---|
Former Name | BRIDGET ELAINE MACLIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 61878) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2011-07-01 |
Last Update Date | 2012-09-27 |