NPI | 1699295352 |
---|---|
Former Name | KATHRYN ELLEN WEBER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: MA DN1857597) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA DN1857597) |
Enumeration Date | 2017-06-23 |
Last Update Date | 2018-03-17 |