| NPI | 1871933531 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 246ZA2600X Specialist/Technologist, Other, Art, Medical (Licence: NY 05-001512) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NY 05-001512) |
| Enumeration Date | 2013-06-26 |
| Last Update Date | 2018-03-17 |