| NPI | 1972847754 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 685518121) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 685515121) |
| Enumeration Date | 2012-11-19 |
| Last Update Date | 2012-11-19 |