NPI | 1811144397 |
---|---|
Former Name | JULIA THERESE BORATENSKI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO 9776) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 57595) |
Enumeration Date | 2008-08-26 |
Last Update Date | 2015-11-03 |