| NPI | 1669463279 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X (Licence: PA MD066735L) |
| Additional Taxonomies | 2085R0001X (Licence: RI 13785) |
| 2085R0001X (Licence: MA 223387) | |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2022-02-15 |