| NPI | 1366852824 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X (Licence: OH 129748) |
| Additional Taxonomies | 2085R0001X (Licence: KS 0437169) |
| 2085R0001X (Licence: MO 2014008708) | |
| Enumeration Date | 2014-05-05 |
| Last Update Date | 2017-01-19 |