| NPI | 1922071430 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: OH 35B72745) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD425984) |
| Enumeration Date | 2006-02-08 |
| Last Update Date | 2011-10-19 |