NPI | 1912246364 |
---|---|
Former Name | LISA ANNETTE BUDA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: CA 62803) |
Additional Taxonomies | 122300000X Dentist (Licence: NY 056520) |
Enumeration Date | 2013-02-05 |
Last Update Date | 2016-03-10 |