| NPI | 1104180421 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 515192111) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 474463101) |
| Enumeration Date | 2012-07-02 |
| Last Update Date | 2012-07-02 |