Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | 41266 | CA |
NPI | 1063545416 |
---|---|
Provider Name | Ann Mineo Kania |
First Address | Encinitas, CA 92024-2787 |
Second Address | Encinitas, CA 92024-2787 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2007 |
Last Update Date | 08/07/2007 |