| NPI | 1639449838 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: 149790) |
| Additional Taxonomies | 174400000X Specialist (Licence: WA MA 60235996) |
| Enumeration Date | 2012-01-04 |
| Last Update Date | 2020-09-21 |