| NPI | 1144747189 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225000000X Orthotic Fitter (Licence: WV CFO04481) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: WV PTA002315) |
| Enumeration Date | 2017-08-29 |
| Last Update Date | 2017-08-29 |