| NPI | 1003354929 |
|---|---|
| Former Name | JAMILA SHANI MCKINNIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AL 6830) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: LA 6907) |
| 1223G0001X Dentist, General Practice (Licence: FL DN23187) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-02-11 |
| Last Update Date | 2022-06-01 |