| NPI | 1346647278 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171W00000X Contractor (Licence: MT 8079) |
| Additional Taxonomies | 171W00000X Contractor (Licence: CO 0016656) |
| Enumeration Date | 2014-11-20 |
| Last Update Date | 2015-07-14 |