| NPI | 1154031615 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: GA CO134520) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: GA CO134520) |
| 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment | |
| 335E00000X Prosthetic/Orthotic Supplier (Licence: GA CO134520) | |
| Enumeration Date | 2022-11-24 |
| Last Update Date | 2022-11-24 |