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 |