| NPI | 1639591068 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 564722111) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 564721111) |
| 174400000X Specialist (Licence: NY 564720111) | |
| 174400000X Specialist (Licence: NY 564719111) | |
| Enumeration Date | 2014-01-21 |
| Last Update Date | 2014-01-21 |