| NPI | 1104379254 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 776850131) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 776851131) |
| 174400000X Specialist (Licence: NY 776849131) | |
| 174400000X Specialist (Licence: NY 776848131) | |
| Enumeration Date | 2016-07-25 |
| Last Update Date | 2016-07-25 |