| NPI | 1194179648 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224L00000X Pedorthist (Licence: WV CFts1828) |
| Additional Taxonomies | 225000000X Orthotic Fitter (Licence: WV CFts1828) |
| Enumeration Date | 2016-04-21 |
| Last Update Date | 2016-04-21 |