| NPI | 1548591324 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225000000X Orthotic Fitter (Licence: NC CFts0820) |
| Additional Taxonomies | 224900000X Mastectomy Fitter (Licence: NC CFm02654) |
| Enumeration Date | 2010-01-19 |
| Last Update Date | 2012-07-30 |