| Street | Deutschhausstrasse 22 | ||
| City/Town | Vipiteno Bolzano | ||
| State/Province/Region | Bolzano/Bozen | ||
| Zip/Postal Code | 39049 | ||
| Phone Number | 0472 764496 | ||
| Country | Italy |
| Full Name | Dr. Thea De rosa | ||
| Gender | female | ||
| Birthday | 1982-04-02 | ||
| Social Security Number | HCDSTB87J02C899G |
| Credit card brand | EnRoute | ||
| Credit card number | 2014943151637445 | ||
| Expire | 2031/6 | ||
| CVV | 508 |