NPI | 1093420093 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 305S00000X Point of Service (Licence: WA 603411759) |
Additional Taxonomies | 305S00000X Point of Service (Licence: WA MC18127) |
Enumeration Date | 2023-01-16 |
Last Update Date | 2023-01-16 |