| NPI | 1306625363 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: NY $$$-$$-$$$$) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 577-2-6458) |
| Enumeration Date | 2023-09-27 |
| Last Update Date | 2023-09-27 |