| NPI | 1730258245 |
|---|---|
| Former Name | SAMAR FAHIM SAMUEL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: MI 2901601624) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 34091) |
| 122300000X Dentist (Licence: CA 52385) | |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2023-09-04 |