| NPI | 1629338496 |
|---|---|
| Former Name | SANDRA CAMPBELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 1032049161) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 711420961) |
| Enumeration Date | 2012-05-25 |
| Last Update Date | 2017-08-03 |