| NPI | 1285296533 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: GA cped4487) |
| Additional Taxonomies | 224L00000X (Licence: cped4487) |
| Enumeration Date | 2019-07-07 |
| Last Update Date | 2019-10-24 |