| NPI | 1518577717 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 224P00000X Prosthetist |
| 224P00000X Prosthetist | |
| 335E00000X Prosthetic/Orthotic Supplier | |
| Enumeration Date | 2020-08-03 |
| Last Update Date | 2024-02-07 |