| NPI | 1912269143 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 1120296) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 2167503) |
| Enumeration Date | 2012-06-13 |
| Last Update Date | 2012-06-13 |