NPI | 1710501382 |
---|---|
Former Name | ELIZABETH ANNE POTEE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: IN 12013761A) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2020-05-30 |
Last Update Date | 2022-12-13 |