NPI | 1942789110 |
---|---|
Former Name | ALICIA DIANE MORRIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: KS 61936) |
Additional Taxonomies | 122300000X Dentist (Licence: TX 34476) |
Enumeration Date | 2018-08-09 |
Last Update Date | 2024-04-09 |