NPI | 1912361247 |
---|---|
Former Name | YVONNE MICHELLE MARTEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: NE 7358) |
Additional Taxonomies | 122300000X Dentist (Licence: NE 137) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2016-04-12 |
Last Update Date | 2022-07-21 |