| NPI | 1528808276 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier | 
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies | 
| Enumeration Date | 2024-05-30 | 
| Last Update Date | 2024-05-30 |