| NPI | 1255758652 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171W00000X Contractor (Licence: TX 178323) |
| Additional Taxonomies | 372600000X Adult Companion (Licence: TX 178323) |
| Enumeration Date | 2014-03-24 |
| Last Update Date | 2017-02-26 |