| NPI | 1093111684 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: MD 404811) |
| Additional Taxonomies | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: MD 311za0620x) |
| Enumeration Date | 2014-11-10 |
| Last Update Date | 2023-02-14 |