| NPI | 1669144317 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171W00000X Contractor (Licence: FL 081972) |
| Additional Taxonomies | 171W00000X Contractor (Licence: FL 091972) |
| Enumeration Date | 2021-10-01 |
| Last Update Date | 2021-10-01 |