| NPI | 1417113440 |
|---|---|
| Former Name | MICHELLE VELASQUEZ-DURON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 59818) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NJ 22DI02383000) |
| Enumeration Date | 2008-07-30 |
| Last Update Date | 2010-10-19 |