| NPI | 1134765167 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 222Z00000X Orthotist (Licence: CO003119) |
| Additional Taxonomies | 224900000X Mastectomy Fitter (Licence: CFM02296) |
| Enumeration Date | 2019-11-25 |
| Last Update Date | 2022-05-31 |