| NPI | 1194856351 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist Periodontics (Licence: RI DEN02556) |
| Additional Taxonomies | 1223P0300X Dentist Periodontics (Licence: MA DN18948) |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2011-12-13 |