NPI | 1659747061 |
---|---|
Former Name | NATALIE RENEE HANSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA DDS105607) |
Additional Taxonomies | 122300000X Dentist (Licence: ID D-4691) |
Enumeration Date | 2015-08-19 |
Last Update Date | 2020-10-26 |