| NPI | 1174057566 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171W00000X Contractor (Licence: NC 15676) |
| Additional Taxonomies | 171W00000X Contractor (Licence: SC 10258) |
| Enumeration Date | 2017-04-12 |
| Last Update Date | 2017-04-12 |