| NPI | 1285179952 |
|---|---|
| Former Name | LARA FIDALGO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: NJ 37PC00598800) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NJ 37AC00212900) |
| Enumeration Date | 2017-01-04 |
| Last Update Date | 2018-02-08 |