| NPI | 1982968590 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: RI DEN03194) |
| Additional Taxonomies | 122300000X Dentist (Licence: ME DEN4249) |
| Enumeration Date | 2012-06-28 |
| Last Update Date | 2014-03-05 |