| NPI | 1699394916 |
|---|---|
| Former Name | CAITLIN SUZANNE WHITAKER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12013403A) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2020-04-16 |
| Last Update Date | 2020-06-26 |