Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | 2901021721 | MI |
NPI | 1003283557 |
---|---|
Provider Name | Karishma M Choksi |
First Address | Detroit, MI 48208-2576 |
Second Address | Detroit, MI 48208 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2015 |
Last Update Date | 25/08/2018 |