| NPI | 1073807673 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 275703) |
| Additional Taxonomies | 174400000X Specialist (Licence: PR 18589) |
| Enumeration Date | 2011-06-01 |
| Last Update Date | 2014-06-27 |