| NPI | 1043496193 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X (Licence: FL ME121276) |
| Additional Taxonomies | 2085R0001X (Licence: WI 51430) |
| 2085R0001X (Licence: IL 125045563) | |
| Enumeration Date | 2008-01-18 |
| Last Update Date | 2018-09-28 |