| NPI | 1356849368 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 105800) |
| Additional Taxonomies | 174400000X Specialist (Licence: 105800) |
| Enumeration Date | 2018-01-24 |
| Last Update Date | 2018-01-24 |