| NPI | 1114588019 |
|---|---|
| Former Name | SAMIYRA VAUGHN-IBRAHIM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: PA DS042140) |
| Enumeration Date | 2019-06-23 |
| Last Update Date | 2026-07-27 |