| NPI | 1396752697 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213ES0131X (Licence: NY N005131) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2009-01-05 |