| NPI | 1629667266 |
|---|---|
| Former Name | SHIRA FENYA BUTT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA DDS106024) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AZ 10562) |
| 1223G0001X Dentist, General Practice (Licence: CA 106024) | |
| Enumeration Date | 2021-01-17 |
| Last Update Date | 2021-03-07 |