| NPI | 1104025113 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X (Licence: SD 9059) |
| Additional Taxonomies | 2085R0001X (Licence: IA R8093) |
| 2085R0001X (Licence: ND 12680) | |
| Enumeration Date | 2007-07-11 |
| Last Update Date | 2023-11-17 |