| NPI | 1255768727 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1744P3200X Specialist, Prosthetics Case Management (Licence: OK 58738) |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency (Licence: OK 58738) |
| Enumeration Date | 2013-09-30 |
| Last Update Date | 2013-09-30 |