| NPI | 1578900601 |
|---|---|
| Former Name | GENA MCGIVERN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: KS 60779) |
| Enumeration Date | 2013-05-30 |
| Last Update Date | 2016-04-26 |