| NPI | 1730312760 |
|---|---|
| Other Name | LOURDES ALEXANDRA MANIBO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: FL DN19387) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: NY 054531) |
| Enumeration Date | 2009-08-25 |
| Last Update Date | 2021-11-11 |