| NPI | 1740703255 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 174400000X Specialist (Licence: NY 993094151)  | 
| Additional Taxonomies | 174400000X Specialist (Licence: NY 993192151)  | 
| 174400000X Specialist (Licence: NY 9931191151)  | |
| 174400000X Specialist (Licence: NY 993193151)  | |
| Enumeration Date | 2017-07-18 | 
| Last Update Date | 2017-07-18 |