| NPI | 1306194915 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X (Licence: CA 20A13213) |
| Additional Taxonomies | 2085R0001X (Licence: IA 1306194915) |
| 2085R0001X (Licence: OH 34.012242) | |
| Enumeration Date | 2012-08-29 |
| Last Update Date | 2026-07-13 |