| NPI | 1528840428 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: GA CO133923) |
| Additional Taxonomies | 1744P3200X Specialist, Prosthetics Case Management (Licence: GA CO133923) |
| 224P00000X Prosthetist (Licence: GA CO133923) | |
| 225000000X Orthotic Fitter (Licence: GA CO133923) | |
| Enumeration Date | 2023-10-17 |
| Last Update Date | 2025-03-25 |