| NPI | 1104037035 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171W00000X Contractor (Licence: OR 10329) |
| Additional Taxonomies | 171W00000X Contractor (Licence: WA MA00021696) |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2011-04-10 |