| NPI | 1710923479 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X (Licence: KY 48102) |
| Additional Taxonomies | 2086S0129X (Licence: PA MD435952) |
| 2086S0129X (Licence: KY TP170) | |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2015-08-12 |