NPI | 1932691920 |
---|---|
Former Name | ADRIENNE M RUNGE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: IN 12013423A) |
Additional Taxonomies | 122300000X Dentist (Licence: NH 04409) |
Enumeration Date | 2018-06-05 |
Last Update Date | 2021-01-04 |