| NPI | 1902335540 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 1103510171) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 1103935171) |
| Enumeration Date | 2017-06-07 |
| Last Update Date | 2017-06-07 |