NPI | 1770747966 |
---|---|
Former Name | MITZI JOHANNA MOLDAUER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: FL DTP502) |
Enumeration Date | 2008-07-16 |
Last Update Date | 2022-01-06 |