| NPI | 1356456040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: OR MD13758) |
| Additional Taxonomies | 174400000X Specialist (Licence: WA MD00034435) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2007-07-08 |