| NPI | 1578563383 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X (Licence: CA G143277) |
| Additional Taxonomies | 2085R0001X (Licence: DC 20025) |
| 2085R0001X (Licence: MD D0042586) | |
| Enumeration Date | 2005-07-22 |
| Last Update Date | 2017-01-17 |