| NPI | 1528545514 |
|---|---|
| Former Name | KELLIE KAWASAKI |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR D10873) |
| Additional Taxonomies | 122300000X Dentist (Licence: OR D10873) |
| Enumeration Date | 2018-07-23 |
| Last Update Date | 2018-07-23 |