NPI | 1134493695 |
---|---|
Other Name | KALISHA NELSON HANLEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: LA 6724) |
Additional Taxonomies | 122300000X Dentist (Licence: LA 6724) |
Enumeration Date | 2012-03-01 |
Last Update Date | 2024-09-19 |