NPI | 1700405719 |
---|---|
Former Name | MALIKAH CHRISTIE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: GA DN122387) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2020-04-09 |
Last Update Date | 2023-08-17 |