| NPI | 1962654814 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X (Licence: ID MC-1427) |
| Additional Taxonomies | 2086S0129X (Licence: MA 257280) |
| 2086S0129X (Licence: CO 00063730) | |
| Enumeration Date | 2008-10-22 |
| Last Update Date | 2022-08-01 |