Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 126800000X | Dental Assistant |
NPI | 1154607109 |
---|---|
Provider Name | Ms. Elizabeth Aguilar |
First Address | Los Angeles, CA 90022-5408 |
Second Address | Los Angeles, CA 90022-5408 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/10/2011 |
Last Update Date | 21/10/2011 |