| NPI | 1952990442 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 246ZA2600X Specialist/Technologist, Other, Art, Medical |
| Additional Taxonomies | 246ZA2600X Specialist/Technologist, Other, Art, Medical (Licence: NY 802-1393) |
| 246ZA2600X Specialist/Technologist, Other, Art, Medical (Licence: NJ 55-203785-TT-A) | |
| Enumeration Date | 2021-01-11 |
| Last Update Date | 2023-02-13 |