| NPI | 1235510496 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0805X (Licence: KY 60982) |
| Additional Taxonomies | 2084P0805X (Licence: SC 37680) |
| 2084P0805X (Licence: GA 88676) | |
| Enumeration Date | 2015-06-13 |
| Last Update Date | 2025-06-20 |