NPI | 1972174795 |
---|---|
Former Name | BRIANA AMOS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN122397) |
Additional Taxonomies | 122300000X Dentist (Licence: GA DN122397) |
Enumeration Date | 2021-07-02 |
Last Update Date | 2024-05-28 |