| NPI | 1124417084 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 549625041) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NY 549625041) |
| Enumeration Date | 2015-01-15 |
| Last Update Date | 2015-01-15 |