| NPI | 1558523373 |
|---|---|
| Former Name | ELIZABETH NICOLE THOMAS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 27884) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN18454) |
| 122300000X Dentist (Licence: MA 22239) | |
| Enumeration Date | 2008-07-02 |
| Last Update Date | 2012-07-13 |