| NPI | 1235714338 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Additional Taxonomies | 224900000X Mastectomy Fitter (Licence: CA CFM03439) |
| Enumeration Date | 2021-03-10 |
| Last Update Date | 2024-01-18 |