| NPI | 1558614792 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 359573091) |
| 174400000X Specialist (Licence: NY 610621122) | |
| 174400000X Specialist (Licence: NY 594134122) | |
| Enumeration Date | 2012-10-25 |
| Last Update Date | 2012-10-25 |