NPI | 1720092133 |
---|---|
Former Name | PAMELA SUE CERMAK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TN 8732) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OH 018573) |
Enumeration Date | 2006-07-28 |
Last Update Date | 2019-03-13 |