| NPI | 1750943569 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 1313962191) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 1313099291) |
| 174400000X Specialist (Licence: NY 1313092191) | |
| 174400000X Specialist (Licence: NY 1312574191) | |
| Enumeration Date | 2019-07-01 |
| Last Update Date | 2019-07-01 |