Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 040087 | NY |
NPI | 1710001540 |
---|---|
Provider Name | Renee Joskow |
First Address | Gaithersburg, MD 20883-3024 |
Second Address | Washington, DC 20593-0002 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/03/2007 |
Last Update Date | 08/07/2007 |