| NPI | 1306217013 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 224900000X Mastectomy Fitter |
| Additional Taxonomies | 1744P3200X Specialist, Prosthetics Case Management (Licence: GA CO098641) |
| Enumeration Date | 2015-10-08 |
| Last Update Date | 2022-07-21 |