| NPI | 1427069897 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X (Licence: PA MD054888L) |
| Additional Taxonomies | 2085R0001X (Licence: NC 2012-02071) |
| 2085R0001X (Licence: OH 35.132895) | |
| 2085R0001X (Licence: FL ME96487) | |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2026-01-26 |