| NPI | 1942224332 |
|---|---|
| Former Name | KELLEY YVONNE STEWART |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: OR D7960) |
| Additional Taxonomies | 122300000X Dentist (Licence: OR D7960) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2011-09-07 |