| NPI | 1962493874 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X (Licence: NY 300242) |
| Additional Taxonomies | 2085R0001X (Licence: NJ 25MA11476700) |
| 2085R0001X (Licence: MA 77022) | |
| Enumeration Date | 2005-10-31 |
| Last Update Date | 2024-11-12 |