| NPI | 1750583985 |
|---|---|
| Former Name | LADEANE KATHERINE FATTORE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ D07776) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NV 4287) |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2015-06-02 |