NPI | 1821501495 |
---|---|
Former Name | CLEO DANUTA STEPHANIDES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019.033150) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: UT 10743908-9922) |
Enumeration Date | 2017-11-06 |
Last Update Date | 2021-08-27 |