| NPI | 1730602202 |
|---|---|
| Former Name | AMELIA SIKES BAXLEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: SC 9847) |
| Additional Taxonomies | 122300000X Dentist (Licence: NC 10788) |
| Enumeration Date | 2017-07-17 |
| Last Update Date | 2021-06-25 |