| NPI | 1053312363 |
|---|---|
| Former Name | HIBA A KELLOW |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: NE 7118) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CO 8639) |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2013-10-08 |