NPI | 1669841565 |
---|---|
Former Name | ZULY FERNANDEZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: FL DN24385) |
Additional Taxonomies | 122300000X Dentist (Licence: PR 003197) |
1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MN D13635) | |
Enumeration Date | 2015-09-21 |
Last Update Date | 2019-09-26 |