| NPI | 1164723151 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Additional Taxonomies | 225000000X Orthotic Fitter (Licence: SC 3976) |
| 247200000X Technician, Other (Licence: SC CFTS3976) | |
| Enumeration Date | 2010-11-08 |
| Last Update Date | 2010-11-08 |