| NPI | 1063628634 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: KS 18-00330) |
| Additional Taxonomies | 174400000X Specialist (Licence: MO 2003012171) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2007-07-08 |