| NPI | 1245857580 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: TX 32066800494) |
| Additional Taxonomies | 247200000X Technician, Other |
| Enumeration Date | 2020-07-02 |
| Last Update Date | 2021-07-13 |