| NPI | 1720452741 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 897179141) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 867730141) |
| 174400000X Specialist (Licence: NY 819264141) | |
| 174400000X Specialist (Licence: NY 819263141) | |
| Enumeration Date | 2015-11-16 |
| Last Update Date | 2015-11-16 |