| NPI | 1154430429 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: TX 203) |
| Additional Taxonomies | 222Z00000X Orthotist (Licence: TX 203) |
| 225100000X Physical Therapist (Licence: TX 1029460) | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2016-05-03 |