| NPI | 1235819632 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225000000X Orthotic Fitter (Licence: TX 1143976) |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2023-07-20 |
| Last Update Date | 2023-12-02 |