| NPI | 1194093393 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: CA 101183) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: CA 18131) |
| 335E00000X Prosthetic/Orthotic Supplier (Licence: CA C17386) | |
| Enumeration Date | 2011-12-02 |
| Last Update Date | 2011-12-02 |