| NPI | 1285826065 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 224900000X Mastectomy Fitter (Licence: DE CFM02153) |
| 224L00000X Pedorthist (Licence: DE CPED0524) | |
| 222Z00000X Orthotist (Licence: MD C15207) | |
| Enumeration Date | 2007-08-15 |
| Last Update Date | 2013-01-11 |