NPI | 1629761507 |
---|---|
Former Name | ABBIGAYLE DUNLAVY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: TX 39572) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2023-05-29 |
Last Update Date | 2023-06-15 |