| NPI | 1053943340 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171W00000X Contractor (Licence: PA PA016151) |
| Additional Taxonomies | 171W00000X Contractor (Licence: OH 1924515) |
| Enumeration Date | 2020-02-05 |
| Last Update Date | 2020-02-05 |