Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | 9822 | NC |
NPI | 1962819185 |
---|---|
Provider Name | Dr. Sasha Jane Betz |
First Address | Cary, NC 27513-5209 |
Second Address | Cary, NC 27513-5209 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2014 |
Last Update Date | 21/07/2014 |