| NPI | 1649808262 |
|---|---|
| Former Name | GRETA-ANNE MARIE CASTONGUAY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: VA 0401416979) |
| Additional Taxonomies | 122300000X Dentist (Licence: VA 04401416979) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-03-30 |
| Last Update Date | 2024-02-13 |