Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 56651 | CA |
NPI | 1104815513 |
---|---|
Provider Name | Mrs. Aparna Aghi |
First Address | San Rafael, CA 94901-3552 |
Second Address | San Rafael, CA 94901-3552 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2005 |
Last Update Date | 06/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
30301490 | (05) | NH |