| NPI | 1104326644 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1744P3200X Specialist, Prosthetics Case Management (Licence: MD 4422469) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 335E00000X Prosthetic/Orthotic Supplier | |
| Enumeration Date | 2018-02-20 |
| Last Update Date | 2022-11-08 |