NPI | 1487795456 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 171W00000X Contractor (Licence: MO 2005023703) |
Additional Taxonomies | 171W00000X Contractor (Licence: KS 17-01026) |
Enumeration Date | 2007-02-10 |
Last Update Date | 2015-03-03 |