| NPI | 1770738841 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171W00000X Contractor (Licence: NY 011886-1) |
| Additional Taxonomies | 171W00000X Contractor (Licence: NJ 46TR00478900) |
| Enumeration Date | 2008-11-17 |
| Last Update Date | 2018-07-09 |