| NPI | 1669826905 |
|---|---|
| Former Name | RADMILA RAFAILOVA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 059175) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2016-04-22 |
| Last Update Date | 2018-03-17 |