| NPI | 1659302552 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: OR MD27332) |
| Additional Taxonomies | 174400000X Specialist (Licence: OH 35088020) |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2022-05-09 |