| NPI | 1902901796 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X (Licence: MO 2025016195) |
| Additional Taxonomies | 2085R0001X (Licence: KS 0451054) |
| 2085R0001X (Licence: TX M1991) | |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2025-07-23 |