| NPI | 1669403358 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition |
| Additional Taxonomies | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies (Licence: FL 04548) |
| 335E00000X Prosthetic/Orthotic Supplier (Licence: FL ORF 148) | |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2007-07-08 |