| NPI | 1972865442 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171W00000X Contractor (Licence: NY 717251962) |
| Additional Taxonomies | 171W00000X Contractor (Licence: NY 486110931) |
| 171W00000X Contractor (Licence: NY 486112931) | |
| Enumeration Date | 2012-06-11 |
| Last Update Date | 2012-06-11 |