| NPI | 1053789602 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224900000X Mastectomy Fitter (Licence: CA C52184) |
| Additional Taxonomies | 222Z00000X Orthotist (Licence: CA C52184) |
| Enumeration Date | 2015-09-11 |
| Last Update Date | 2024-02-27 |