| NPI | 1699036491 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: CO PT 0012076) |
| Additional Taxonomies | 174400000X Specialist (Licence: CO MT-12963) |
| Enumeration Date | 2012-06-07 |
| Last Update Date | 2014-03-21 |