| NPI | 1013079367 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X (Licence: MA 249119) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital (Licence: MA 218029) |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2013-10-02 |