| NPI | 1548654411 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225000000X Orthotic Fitter |
| Additional Taxonomies | 174400000X Specialist (Licence: GA CO093014) |
| 1744P3200X Specialist, Prosthetics Case Management (Licence: GA CO093014) | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2015-03-27 |
| Last Update Date | 2020-04-02 |