| NPI | 1396943023 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171W00000X Contractor (Licence: TX MT015603) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX MT015603) |
| Enumeration Date | 2007-07-03 |
| Last Update Date | 2007-07-08 |