| NPI | 1053636092 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: KS 04-39438) |
| Additional Taxonomies | 174400000X Specialist (Licence: MO 2014015770) |
| Enumeration Date | 2010-04-01 |
| Last Update Date | 2019-03-22 |