| NPI | 1336516418 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: TN 071360) |
| Additional Taxonomies | 1744P3200X Specialist, Prosthetics Case Management (Licence: TN 0000071360) |
| Enumeration Date | 2015-08-25 |
| Last Update Date | 2026-04-30 |