| NPI | 1639811169 |
|---|---|
| Former Name | ANNA NICOLE FAULKNER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IA DDS-09991) |
| Additional Taxonomies | 122300000X Dentist (Licence: IA DDS-09991) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2022-04-13 |
| Last Update Date | 2022-08-16 |