| NPI | 1699080291 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CO DEN.00010085) |
| Additional Taxonomies | 122300000X Dentist (Licence: ME DEN4152) |
| Enumeration Date | 2010-08-09 |
| Last Update Date | 2016-08-11 |