NPI | 1861825150 |
---|---|
Former Name | CHRISTINA CUSHMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: PR 3452) |
Enumeration Date | 2013-08-09 |
Last Update Date | 2023-03-01 |