| NPI | 1255990255 |
|---|---|
| Former Name | JACQUELINE ROSE VERA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 13641) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NH 04492) |
| Enumeration Date | 2019-06-12 |
| Last Update Date | 2024-12-16 |