Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 19934 | TX |
NPI | 1073631842 |
---|---|
Provider Name | Dr. Christine See Gin |
First Address | Schaumburg, IL 60173-4144 |
Second Address | Schaumburg, IL 60173-4144 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2007 |
Last Update Date | 22/02/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
171853801 | (05) | TX |