| NPI | 1992122550 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171W00000X Contractor (Licence: TX 100578) |
| Additional Taxonomies | 171W00000X Contractor (Licence: MS OT335) |
| Enumeration Date | 2014-03-20 |
| Last Update Date | 2014-03-20 |