| NPI | 1720059918 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X (Licence: NM MD2014-0053) |
| Additional Taxonomies | 2085R0001X (Licence: PA MD062281L) |
| 2085R0001X (Licence: WV 21017) | |
| 2085R0001X (Licence: KY 38627) | |
| Enumeration Date | 2006-01-27 |
| Last Update Date | 2022-03-25 |