| NPI | 1528701497 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 222Z00000X (Licence: WA OI61107101) |
| Additional Taxonomies | 224P00000X Prosthetist (Licence: WA PS61107102) |
| Enumeration Date | 2022-04-18 |
| Last Update Date | 2022-04-18 |