| NPI | 1598498784 | 
|---|---|
| Former Name | OLUWASEUN PEROSOLA BANJO | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 122300000X Dentist (Licence: MD 17837) | 
| Additional Taxonomies | 122300000X Dentist (Licence: DC DEN2000185) | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2022-07-05 | 
| Last Update Date | 2023-07-06 |