| NPI | 1033473715 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 222Z00000X (Licence: NJ 45OR00003100) |
| Additional Taxonomies | 224P00000X Prosthetist (Licence: NJ 45PR00003500) |
| Enumeration Date | 2012-06-27 |
| Last Update Date | 2022-09-13 |