| NPI | 1174823082 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: AZ 19400823) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: AZ MT-03688P) |
| Enumeration Date | 2010-10-26 |
| Last Update Date | 2026-06-22 |