| NPI | 1558921932 |
|---|---|
| Former Name | KERBY ROXANNE BRAXTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC 9360) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NC 11027) |
| Enumeration Date | 2019-06-18 |
| Last Update Date | 2024-05-08 |