| NPI | 1124382528 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 567820111) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 567823111) |
| Enumeration Date | 2012-06-29 |
| Last Update Date | 2016-04-03 |