| NPI | 1780096362 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 824729141) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 846472141) |
| Enumeration Date | 2014-05-29 |
| Last Update Date | 2014-05-29 |