| NPI | 1639524630 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 970388151) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 970128151) |
| Enumeration Date | 2016-04-27 |
| Last Update Date | 2016-04-27 |