| 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 |