| NPI | 1972177780 |
|---|---|
| Former Name | GABRIELA ALEJANDRA IBARRA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: OH 30.026775) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MN D14651) |
| Enumeration Date | 2021-05-17 |
| Last Update Date | 2022-10-05 |