NPI | 1083857783 |
---|---|
Former Name | RIINA LOBANOV |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: PA DS038217) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA DL10076) |
Enumeration Date | 2009-04-09 |
Last Update Date | 2022-03-23 |