| NPI | 1619320041 |
|---|---|
| Former Name | CATHERINE MANZANO REYES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 100468) |
| Additional Taxonomies | 122300000X Dentist (Licence: NV 6858) |
| Enumeration Date | 2016-07-20 |
| Last Update Date | 2024-07-29 |