NPI | 1669814455 |
---|---|
Former Name | CHRISTABELLE MITCHELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: WI 1001037) |
Additional Taxonomies | 122300000X Dentist (Licence: IL 019029549) |
Enumeration Date | 2013-07-23 |
Last Update Date | 2021-05-04 |