| NPI | 1033392717 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: NC CFTS0275) |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier (Licence: NC CFOM0662) |
| Enumeration Date | 2007-12-17 |
| Last Update Date | 2011-05-02 |