| NPI | 1780904771 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: UT 348791-4701) |
| Additional Taxonomies | 174400000X Specialist (Licence: CO 6315) |
| Enumeration Date | 2010-06-02 |
| Last Update Date | 2010-06-02 |