| NPI | 1417323304 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies (Licence: FL 1155) |
| Enumeration Date | 2015-08-14 |
| Last Update Date | 2015-08-14 |