NPI | 1063503100 |
---|---|
Former Name | KYLE IVY COHEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 174400000X Specialist (Licence: OR 12687) |
Additional Taxonomies | 174400000X Specialist (Licence: WA 00034920) |
Enumeration Date | 2006-09-27 |
Last Update Date | 2007-07-08 |