NPI | 1932228566 |
---|---|
Former Name | JENNIFER LEAH BOWMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: WA DE00010283) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WA DE00010283) |
Enumeration Date | 2007-03-28 |
Last Update Date | 2024-12-13 |