| NPI | 1770733487 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171W00000X Contractor (Licence: OR LMT #15469) |
| Additional Taxonomies | 174400000X Specialist (Licence: OR LMT #115469) |
| Enumeration Date | 2008-09-30 |
| Last Update Date | 2008-09-30 |