NPI | 1588997621 |
---|---|
Former Name | DRILONA KELLICI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 054487) |
Additional Taxonomies | 122300000X Dentist (Licence: NY 054487) |
Enumeration Date | 2009-09-08 |
Last Update Date | 2018-05-10 |