Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223P0106X | Oral and Maxillofacial Pathology | 052700 | NY |
Y | 1223P0106X | Oral and Maxillofacial Pathology | S1-27C | NV |
NPI | 1265620181 |
---|---|
Provider Name | Dr. Sonal S Shah |
First Address | Las Vegas, NV 89145-8838 |
Second Address | Las Vegas, NV 89102-2335 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2007 |
Last Update Date | 25/10/2021 |