NPI | 1952877557 |
---|---|
Former Name | LEAH MICHELLE YOUNG |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: KY 10224) |
Additional Taxonomies | 122300000X Dentist (Licence: IN 12013069A) |
1223G0001X Dentist, General Practice (Licence: IN 12013069A) | |
1223G0001X Dentist, General Practice (Licence: KY 10224) | |
Enumeration Date | 2018-10-22 |
Last Update Date | 2020-08-12 |