| NPI | 1013325794 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 174400000X Specialist (Licence: NY 618165121)  | 
| Additional Taxonomies | 174400000X Specialist (Licence: NY 618164121)  | 
| Enumeration Date | 2014-07-26 | 
| Last Update Date | 2014-07-26 |