| NPI | 1902347933 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NJ 45OR00010500) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA POH000015) |
| Enumeration Date | 2017-03-09 |
| Last Update Date | 2017-03-09 |