| NPI | 1750334769 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X (Licence: RI MD20763) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL ME84263) |
| 2085R0001X (Licence: FL ME84263) | |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2025-09-24 |