| NPI | 1063757896 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 391290101) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 391267101) |
| Enumeration Date | 2012-12-05 |
| Last Update Date | 2012-12-05 |