| NPI | 1386795078 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: TX 0012233) |
| Additional Taxonomies | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition |
| 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies (Licence: TX 0072935) | |
| 335E00000X Prosthetic/Orthotic Supplier | |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2008-02-14 |