| NPI | 1639374838 |
|---|---|
| Former Name | KATHERINE VALENTINE SHADEGG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: AZ 8840) |
| Additional Taxonomies | 122300000X Dentist (Licence: NE 6705) |
| Enumeration Date | 2007-06-18 |
| Last Update Date | 2020-12-23 |