| NPI | 1013458827 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224L00000X Pedorthist (Licence: IL 212.000178) |
| Additional Taxonomies | 224900000X Mastectomy Fitter |
| 225000000X Orthotic Fitter | |
| Enumeration Date | 2017-03-13 |
| Last Update Date | 2021-12-22 |