| NPI | 1508904772 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213ES0131X (Licence: MD 01457) |
| Additional Taxonomies | 213ES0131X (Licence: GA POD001068) |
| 213ES0131X (Licence: FL PO3100) | |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2021-09-20 |