NPI | 1144541095 |
---|---|
Former Name | JESSICA JINHEE LEE HERTIG |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: AL D.6440C) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: CO DEN.00010662) |
Enumeration Date | 2010-06-15 |
Last Update Date | 2024-06-28 |