NPI | 1720599897 |
---|---|
Former Name | SABRINA ALEXA STEWART |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: FL DN28588) |
Additional Taxonomies | 122300000X Dentist (Licence: AL 6469) |
Enumeration Date | 2017-10-17 |
Last Update Date | 2023-09-10 |