| NPI | 1306158100 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 174400000X Specialist (Licence: TX 113667) | 
| Additional Taxonomies | 174400000X Specialist (Licence: MD 06224) | 
| Enumeration Date | 2010-07-08 | 
| Last Update Date | 2010-07-08 |