| NPI | 1043979990 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 335G00000X Medical Foods Supplier |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 332U00000X Home Delivered Meals | |
| Enumeration Date | 2021-12-08 |
| Last Update Date | 2021-12-13 |