NPI | 1861808487 |
---|---|
Former Name | MCKENNA ASHLI RHEA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AL 6232) |
Additional Taxonomies | 122300000X Dentist (Licence: AL 6232) |
1223G0001X Dentist, General Practice (Licence: TX 30262) | |
Enumeration Date | 2014-07-02 |
Last Update Date | 2019-02-07 |