| NPI | 1629409198 |
|---|---|
| Former Name | SUSAN YVONNE SHIPMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: TX 101300) |
| Enumeration Date | 2013-12-09 |
| Last Update Date | 2013-12-09 |