NPI | 1710029376 |
---|---|
Former Name | BECKY COOK VAN GEMERT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: WA 10216) |
Additional Taxonomies | 122300000X Dentist (Licence: WA 10216) |
Enumeration Date | 2007-02-12 |
Last Update Date | 2011-03-07 |