| NPI | 1124401989 |
|---|---|
| Former Name | ERIN ELYSSA DANIELS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: IA 09512) |
| Additional Taxonomies | 122300000X Dentist (Licence: KS 61228) |
| Enumeration Date | 2015-06-29 |
| Last Update Date | 2019-10-17 |