Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 126800000X | Dental Assistant |
NPI | 1013518331 |
---|---|
Provider Name | Karina Madelline Morales Sandoval |
First Address | Aberdeen Proving Ground, MD 21005 |
Second Address | Aberdeen Proving Ground, MD 21005 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2020 |
Last Update Date | 03/11/2020 |