| NPI | 1194563767 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: TN 207921) |
| Additional Taxonomies | 1744P3200X Specialist, Prosthetics Case Management (Licence: TN 207921) |
| 335E00000X Prosthetic/Orthotic Supplier (Licence: TN 207921) | |
| Enumeration Date | 2024-07-18 |
| Last Update Date | 2024-07-18 |