| NPI | 1033837422 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: VA 1301094054) |
| Additional Taxonomies | 174400000X Specialist (Licence: VA 1301094054) |
| 335E00000X Prosthetic/Orthotic Supplier (Licence: VA 1301094054) | |
| Enumeration Date | 2022-08-22 |
| Last Update Date | 2023-03-07 |