Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | DN20516 | MA |
NPI | 1003306317 |
---|---|
Provider Name | Dr. Nina Tsai |
First Address | Balerna, TI -6828 |
Second Address | Balerna, TI -6828 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2018 |
Last Update Date | 11/05/2018 |