| NPI | 1477550283 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 24799) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: TN MD024799) |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2014-11-26 |