| NPI | 1356544050 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171W00000X Contractor (Licence: KS 17-00806) |
| Additional Taxonomies | 171W00000X Contractor (Licence: MO 002354) |
| Enumeration Date | 2007-06-08 |
| Last Update Date | 2007-07-08 |