| NPI | 1235477910 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 224L00000X Pedorthist (Licence: CA cped2182) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2013-01-30 |
| Last Update Date | 2021-06-18 |