| NPI | 1760996938 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment (Licence: VA 1204017518) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment (Licence: NY 22RO00331168) |
| Enumeration Date | 2017-11-27 |
| Last Update Date | 2018-03-17 |