| NPI | 1912342437 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0131X (Licence: NY 006776) |
| Additional Taxonomies | 213ES0131X (Licence: PA 006444) |
| 213ES0131X (Licence: CT 599) | |
| Enumeration Date | 2013-05-10 |
| Last Update Date | 2019-05-14 |