| NPI | 1376914093 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 587567111) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 587566111) |
| Enumeration Date | 2015-10-08 |
| Last Update Date | 2015-10-08 |