| NPI | 1417215864 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: NJ 40QA00637600) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 014632-1) |
| Enumeration Date | 2012-04-23 |
| Last Update Date | 2012-04-23 |