| NPI | 1962840124 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Additional Taxonomies | 171W00000X Contractor |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2013-06-10 |
| Last Update Date | 2022-03-13 |