| NPI | 1639433279 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 559058111) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 559060111) |
| 174400000X Specialist (Licence: NY 559059111) | |
| 174400000X Specialist (Licence: NY 559057111) | |
| Enumeration Date | 2012-06-28 |
| Last Update Date | 2012-06-28 |