| NPI | 1356603765 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 458865101) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 459174101) |
| 174400000X Specialist (Licence: NY 612550121) | |
| Enumeration Date | 2012-06-12 |
| Last Update Date | 2012-06-12 |