NPI | 1710293022 |
---|---|
Former Name | KATHERINE MICHELLE POKRAS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 59513) |
Additional Taxonomies | 122300000X Dentist (Licence: CA 59513) |
Enumeration Date | 2010-08-24 |
Last Update Date | 2015-03-03 |