NPI | 1639391550 |
---|---|
Professional Name | SOULAFA SUSAN BALOUL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: MA DN20656) |
Additional Taxonomies | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: TX 27643) |
Enumeration Date | 2007-05-02 |
Last Update Date | 2021-07-26 |