Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | DN23506 | FL |
NPI | 1003300435 |
---|---|
Provider Name | Dr. Veena Manhar Gosai |
First Address | Jacksonville, FL 32202-4953 |
Second Address | Jacksonville, FL 32214-5005 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2018 |
Last Update Date | 19/06/2018 |