| NPI | 1356685119 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: CA G47410) |
| Additional Taxonomies | 174400000X Specialist (Licence: CT 030326) |
| 174400000X Specialist (Licence: NY 150281-1) | |
| Enumeration Date | 2012-11-18 |
| Last Update Date | 2012-11-18 |