| NPI | 1538397047 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 222Z00000X Orthotist (Licence: WA OI60444179) |
| Additional Taxonomies | 225000000X Orthotic Fitter (Licence: DE CPO002069) |
| 224P00000X Prosthetist (Licence: WA PS60444370) | |
| Enumeration Date | 2009-06-24 |
| Last Update Date | 2015-08-18 |