| NPI | 1164820791 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: TX 1400920) |
| Additional Taxonomies | 174H00000X Health Educator (Licence: TX 1400920) |
| 335E00000X Prosthetic/Orthotic Supplier (Licence: TX 1400920) | |
| Enumeration Date | 2014-12-13 |
| Last Update Date | 2014-12-13 |