| NPI | 1902299001 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 224900000X Mastectomy Fitter (Licence: NC C51971) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment | |
| 332BX2000X Durable Medical Equipment & Medical Supplies Oxygen Equipment & Supplies | |
| 335E00000X Prosthetic/Orthotic Supplier (Licence: NC C51971) | |
| Enumeration Date | 2015-03-13 |
| Last Update Date | 2022-07-21 |