| NPI | 1194902155 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 222Z00000X (Licence: VA OI00000482) |
| Additional Taxonomies | 224P00000X Prosthetist (Licence: WA PS60070337) |
| Enumeration Date | 2008-01-22 |
| Last Update Date | 2020-09-30 |