| NPI | 1962090928 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition (Licence: TX 1635676) |
| Enumeration Date | 2021-01-05 |
| Last Update Date | 2021-01-05 |