| NPI | 1104169515 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X (Licence: IL 036174688) |
| Additional Taxonomies | 2085R0001X (Licence: NY 294204) |
| 2085R0001X (Licence: NJ 25MA10365100) | |
| Enumeration Date | 2013-04-03 |
| Last Update Date | 2025-05-22 |