| NPI | 1962513366 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: NJ 25MA06229000) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 1940031) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2008-06-26 |