NPI | 1063963049 |
---|---|
Former Name | BROOKE RAE MILLER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: DC DEN1001628) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: DC 1001628) |
Enumeration Date | 2016-10-14 |
Last Update Date | 2023-11-14 |