| NPI | 1417338609 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174200000X Meals (Licence: MI C455793630605) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment | |
| 335E00000X Prosthetic/Orthotic Supplier | |
| Enumeration Date | 2015-06-12 |
| Last Update Date | 2026-08-15 |