NPI | 1770894149 |
---|---|
Former Name | ALEXIS MARTHAJANE FRASER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC 9840) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NH 03858) |
122300000X Dentist (Licence: ME 4412) | |
Enumeration Date | 2010-06-30 |
Last Update Date | 2025-04-15 |