| NPI | 1487767745 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 222Z00000X (Licence: TX CPO-1994) |
| Additional Taxonomies | 222Z00000X (Licence: TX LPO-362) |
| 224P00000X Prosthetist (Licence: TX CPO-1994) | |
| 224P00000X Prosthetist (Licence: TX LPO-362) | |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2008-10-07 |