Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | 22DI02876600 | NJ |
NPI | 1386269652 |
---|---|
Provider Name | Yingci Liu |
First Address | Newark, NJ 07103-2495 |
Second Address | Newark, NJ 07103-2495 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2020 |
Last Update Date | 12/01/2022 |