| NPI | 1013335132 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171W00000X Contractor (Licence: MN 100577) |
| Additional Taxonomies | 171W00000X Contractor (Licence: WA OT 60446052) |
| 171W00000X Contractor (Licence: AR OTR2691) | |
| Enumeration Date | 2014-04-05 |
| Last Update Date | 2014-04-05 |