| NPI | 1518212190 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 632812121) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 632817121) |
| 174400000X Specialist (Licence: NY 632816121) | |
| 174400000X Specialist (Licence: NY 632811121) | |
| Enumeration Date | 2012-07-19 |
| Last Update Date | 2012-07-19 |