| NPI | 1053476283 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X (Licence: MN 73336) |
| Additional Taxonomies | 2085R0001X (Licence: WI 83422) |
| 2085R0001X (Licence: OH 35.097949) | |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2025-12-16 |