| NPI | 1902086192 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: ME102548) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 246454) |
| Enumeration Date | 2007-11-06 |
| Last Update Date | 2008-11-10 |