| NPI | 1740530237 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 669602121) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 653695121) |
| Enumeration Date | 2012-09-12 |
| Last Update Date | 2014-07-31 |