| NPI | 1285727883 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X (Licence: NM MD2016-0160) |
| Additional Taxonomies | 2085R0001X (Licence: TX M2613) |
| 2085R0001X (Licence: NY 255684) | |
| 2085R0001X (Licence: AK 7289) | |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2018-09-27 |