| NPI | 1164135810 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Additional Taxonomies | 1744P3200X Specialist, Prosthetics Case Management |
| 224900000X Mastectomy Fitter | |
| 224P00000X Prosthetist | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 335E00000X Prosthetic/Orthotic Supplier | |
| Enumeration Date | 2022-12-27 |
| Last Update Date | 2024-04-01 |