| NPI | 1588218077 |
|---|---|
| Professional Name | MALISSA FREDERIQUE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 061360) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 061360-01) |
| Enumeration Date | 2019-08-01 |
| Last Update Date | 2025-03-12 |