| NPI | 1609019884 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: ME 4614) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: ME RDH3593) |
| Enumeration Date | 2009-04-17 |
| Last Update Date | 2018-06-04 |