NPI | 1629087408 |
---|---|
Former Name | SUSAN ISABEL ALVAREZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: KY 8681) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WA DE00009344) |
Enumeration Date | 2006-08-07 |
Last Update Date | 2017-01-16 |