| NPI | 1740679950 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 909596151) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 433920101) |
| 174400000X Specialist (Licence: NY 434127101) | |
| Enumeration Date | 2015-01-12 |
| Last Update Date | 2015-01-12 |