| NPI | 1629116983 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NM 91-135) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX L4166) |
| 174400000X Specialist (Licence: FL 59808) | |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2011-11-17 |