| NPI | 1164830220 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171W00000X Contractor (Licence: WA 111300) |
| Additional Taxonomies | 171W00000X Contractor (Licence: WA 512800) |
| Enumeration Date | 2014-07-31 |
| Last Update Date | 2014-07-31 |