| NPI | 1902952070 |
|---|---|
| Former Name | RENALIE REBONG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NV S6-108) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 55087) |
| 1223G0001X Dentist, General Practice (Licence: NV 5176) | |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: NV 5176) | |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2016-06-27 |