Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | 61294 | KS |
NPI | 1063760486 |
---|---|
Provider Name | Rei Sekiguchi |
First Address | Bethesda, MD 20892-4370 |
Second Address | Bethesda, MD 20892-4370 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2012 |
Last Update Date | 10/09/2021 |