NPI | 1811300643 |
---|---|
Former Name | MARILEE YOUNG-MILLER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: CO DEN.00203834) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 30003) |
Enumeration Date | 2014-06-10 |
Last Update Date | 2019-02-19 |