| NPI | 1780072819 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 819176141) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 890171141) |
| 174400000X Specialist (Licence: NY 890049141) | |
| 174400000X Specialist (Licence: NY 81917514) | |
| Enumeration Date | 2014-12-23 |
| Last Update Date | 2017-05-11 |