| NPI | 1801296165 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 838415141) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 838414141) |
| 174400000X Specialist (Licence: NY 852044141) | |
| 174400000X Specialist (Licence: NY 852045141) | |
| Enumeration Date | 2014-08-23 |
| Last Update Date | 2014-08-23 |