| NPI | 1902512536 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 174400000X Specialist |
| 174400000X Specialist (Licence: NY 24469) | |
| Enumeration Date | 2023-01-26 |
| Last Update Date | 2023-01-26 |