| NPI | 1124058656 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: CA 45423) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL MA34028) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2016-03-01 |