| NPI | 1023325149 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: NC C80326) |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier (Licence: NC C80326) |
| Enumeration Date | 2010-09-10 |
| Last Update Date | 2010-09-23 |