| NPI | 1609282144 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171W00000X Contractor (Licence: AZ MT-20184) |
| Additional Taxonomies | 171W00000X Contractor (Licence: NM 7688) |
| Enumeration Date | 2014-07-04 |
| Last Update Date | 2014-07-04 |