| NPI | 1669806808 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 174400000X Specialist (Licence: ID 3389) |
| Enumeration Date | 2013-08-23 |
| Last Update Date | 2016-05-26 |