NPI | 1811649155 |
---|---|
Former Name | ANNA ANDREEVA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: WA DE61195354) |
Additional Taxonomies | 122300000X Dentist (Licence: WA DE61195354) |
Enumeration Date | 2022-01-18 |
Last Update Date | 2022-03-30 |