| NPI | 1316762107 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 224900000X Mastectomy Fitter (Licence: PA 2057) |
| Additional Taxonomies | 222Z00000X Orthotist (Licence: PA OH000038) |
| 224P00000X Prosthetist (Licence: PA PO000018) | |
| Enumeration Date | 2024-11-18 |
| Last Update Date | 2024-11-18 |