| NPI | 1154520807 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X (Licence: NJ 25MA08481500) |
| Additional Taxonomies | 2085N0700X (Licence: MD T2460) |
| 2085N0700X (Licence: PA MD467666) | |
| Enumeration Date | 2007-07-13 |
| Last Update Date | 2019-06-24 |