| NPI | 1700112836 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 038594-01) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA PT019793) |
| Enumeration Date | 2009-10-24 |
| Last Update Date | 2020-03-11 |