| NPI | 1023073517 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Additional Taxonomies | 225000000X Orthotic Fitter (Licence: NC CFom0204) |
| 229N00000X Anaplastologist | |
| 224900000X Mastectomy Fitter | |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2013-10-01 |