| NPI | 1528514684 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171W00000X Contractor (Licence: OR 22424) |
| Additional Taxonomies | 171W00000X Contractor (Licence: HI 14813) |
| Enumeration Date | 2016-08-29 |
| Last Update Date | 2016-08-29 |