| NPI | 1629004056 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 023932-1) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 017840-1) |
| Enumeration Date | 2006-06-25 |
| Last Update Date | 2019-02-05 |