NPI | 1700172889 |
---|---|
Former Name | SAYAKA KONDO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA DE60746344) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 27115) |
Enumeration Date | 2011-06-27 |
Last Update Date | 2017-10-23 |