| 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 | 2025-03-04 |