| NPI | 1962439976 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X (Licence: PA MD418289) |
| Additional Taxonomies | 2085R0001X (Licence: NJ 25MA007765800) |
| 2085R0001X (Licence: MA 237796) | |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2010-06-09 |