| NPI | 1588287973 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 222Z00000X (Licence: WA OI60965930) |
| Additional Taxonomies | 224P00000X Prosthetist (Licence: WA PS60998413) |
| Enumeration Date | 2020-05-20 |
| Last Update Date | 2020-05-20 |