| NPI | 1649339052 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 174400000X Specialist (Licence: DC MD034791) | 
| Additional Taxonomies | 174400000X Specialist (Licence: VA 0101233274) | 
| Enumeration Date | 2006-12-08 | 
| Last Update Date | 2007-07-09 |