| NPI | 1689150708 |
|---|---|
| Former Name | KATHERINE ELIZABETH MICHAELS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171000000X Military Health Care Provider (Licence: TX 34312) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 34312) |
| Enumeration Date | 2018-07-11 |
| Last Update Date | 2023-08-22 |