| NPI | 1407119829 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 569696111) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 569695111) |
| Enumeration Date | 2012-06-20 |
| Last Update Date | 2012-06-20 |