NPI | 1972290955 |
---|---|
Former Name | SUSANNA OLUWADUNNI OLOFINTUYI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA DL15884) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA DL15618) |
Enumeration Date | 2023-04-20 |
Last Update Date | 2023-09-07 |