| NPI | 1548581937 |
|---|---|
| Former Name | JESSICA Y HANNAH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MO 2010016296) |
| Additional Taxonomies | 122300000X Dentist (Licence: MT 2466) |
| 122300000X Dentist (Licence: IN 12011923A) | |
| Enumeration Date | 2010-06-20 |
| Last Update Date | 2017-03-31 |