| NPI | 1588891220 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X (Licence: NY 279367) |
| Additional Taxonomies | 2086S0129X (Licence: PA MT194688) |
| 2086S0129X (Licence: NH RT-2136) | |
| Enumeration Date | 2009-06-21 |
| Last Update Date | 2022-07-21 |