NPI | 1114004579 |
---|---|
Former Name | MIKELLE LOUELLA KUEHN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: WA MD60797389) |
Additional Taxonomies | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: GA DN012237) |
Enumeration Date | 2006-11-01 |
Last Update Date | 2023-02-17 |