| NPI | 1164423232 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X (Licence: FL ME50372) |
| Additional Taxonomies | 2085R0001X (Licence: IA 34500) |
| 2085R0001X (Licence: WV 24703) | |
| Enumeration Date | 2005-08-10 |
| Last Update Date | 2024-01-23 |