| NPI | 1942462122 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171W00000X Contractor (Licence: KY R2270) |
| Additional Taxonomies | 171W00000X Contractor (Licence: KY KY-R2270) |
| Enumeration Date | 2008-06-27 |
| Last Update Date | 2008-06-27 |