| NPI | 1912862046 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171W00000X Contractor (Licence: AL 52207) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: AL 52207) |
| Enumeration Date | 2025-12-20 |
| Last Update Date | 2025-12-20 |