| NPI | 1669660643 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171W00000X Contractor (Licence: TX 1347) |
| Additional Taxonomies | 171W00000X Contractor (Licence: TX MT 1347) |
| Enumeration Date | 2007-10-04 |
| Last Update Date | 2007-10-04 |