| NPI | 1952510299 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X (Licence: OH 35C.002869) |
| Additional Taxonomies | 2086S0129X (Licence: FL ME150243) |
| 2086S0129X (Licence: VA 0101244277) | |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2025-07-30 |