| NPI | 1609010685 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: VA CFO01950) |
| Additional Taxonomies | 225000000X Orthotic Fitter (Licence: VA CFO01950) |
| Enumeration Date | 2009-04-22 |
| Last Update Date | 2009-04-22 |