| NPI | 1164763041 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 717293131) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 717241131) |
| Enumeration Date | 2013-03-02 |
| Last Update Date | 2013-03-02 |