| NPI | 1316910888 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 122300000X Dentist (Licence: ME 3482) |
| Additional Taxonomies | 1223P0300X Dentist Periodontics (Licence: ME 3482) |
| Enumeration Date | 2006-02-07 |
| Last Update Date | 2007-07-08 |