| NPI | 1962541995 |
|---|---|
| Former Name | COREY FREY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MO 2006016427) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NM 13-2006) |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2023-11-29 |