| NPI | 1063776466 |
|---|---|
| Former Name | MEGAN E STATKEWICZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0131X (Licence: CA E6005) |
| Additional Taxonomies | 213ES0131X (Licence: PA Sc006389) |
| Enumeration Date | 2012-06-29 |
| Last Update Date | 2025-04-08 |