| NPI | 1720064892 |
|---|---|
| Former Name | ERIN P WALSH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: KS 60443) |
| Additional Taxonomies | 122300000X Dentist (Licence: MO 2001013729) |
| Enumeration Date | 2005-12-20 |
| Last Update Date | 2020-07-31 |