| NPI | 1508811654 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X (Licence: WI 69611-20) |
| Additional Taxonomies | 2085R0001X (Licence: NY 239860) |
| 2085R0001X (Licence: MI SF078490) | |
| 2085R0001X (Licence: OH 091524) | |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2018-08-06 |