| NPI | 1619425543 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 634560121) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 939008151) |
| 174400000X Specialist (Licence: NY 634559121) | |
| Enumeration Date | 2016-09-20 |
| Last Update Date | 2016-09-20 |