| NPI | 1710262209 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: CT 043363) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: CT 043363) |
| Enumeration Date | 2011-10-15 |
| Last Update Date | 2011-10-15 |