| NPI | 1205170982 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X (Licence: TN 69933) |
| Additional Taxonomies | 2085R0001X (Licence: CA xxxxxxx) |
| 2085R0001X (Licence: FL ME142392) | |
| Enumeration Date | 2012-11-19 |
| Last Update Date | 2025-11-25 |