| NPI | 1639432578 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 610047121) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 619098121) |
| Enumeration Date | 2012-06-15 |
| Last Update Date | 2012-06-15 |