Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 224P00000X | Prosthetist |
NPI | 1487317970 |
---|---|
Provider Name | Denika Williams |
First Address | Southfield, MI 48037-2654 |
Second Address | Bloomfield Hills, MI 48301-3163 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/10/2021 |
Last Update Date | 21/10/2021 |