NPI | 1366504078 |
---|---|
Former Name | MICHELLE BRENDA BROWN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019023014) |
Additional Taxonomies | 122300000X Dentist (Licence: IN 12011745A) |
1223G0001X Dentist, General Practice (Licence: IN 12011745A) | |
Enumeration Date | 2006-12-16 |
Last Update Date | 2023-11-03 |