| NPI | 1841497179 |
|---|---|
| Former Name | KATIE EILEEN EASTON |
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 2901020548) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019.027567) |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2012-03-27 |