| NPI | 1811144397 |
|---|---|
| Former Name | JULIA THERESE BORATENSKI |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CO 9776) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: CA 57595) |
| Enumeration Date | 2008-08-26 |
| Last Update Date | 2015-11-03 |