NPI | 1609916642 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 171W00000X Contractor (Licence: OH 11651) |
Additional Taxonomies | 171W00000X Contractor (Licence: KY 0268) |
Enumeration Date | 2007-02-07 |
Last Update Date | 2007-07-08 |