| NPI | 1225808512 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier |
| 335E00000X Prosthetic/Orthotic Supplier | |
| Enumeration Date | 2024-01-08 |
| Last Update Date | 2024-01-08 |