| NPI | 1164942397 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X (Licence: CA A194137) |
| Additional Taxonomies | 2086S0129X (Licence: OR MD230403) |
| 2086S0129X (Licence: WA MD.MD.70134189) | |
| Enumeration Date | 2017-06-20 |
| Last Update Date | 2026-09-16 |