| NPI | 1053734707 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 817616141) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 817617141) |
| Enumeration Date | 2014-01-31 |
| Last Update Date | 2014-04-14 |