NPI | 1184118127 |
---|---|
Former Name | ERICA ANN BOFFI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: RI DEN03449) |
Additional Taxonomies | 122300000X Dentist (Licence: ME 4652) |
Enumeration Date | 2018-06-21 |
Last Update Date | 2019-06-07 |