| NPI | 1609317577 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1744P3200X Specialist Prosthetics Case Management (Licence: MI 2701237300) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: MI 2701237300) |
| 335E00000X Prosthetic/Orthotic Supplier (Licence: MI 2701237300) | |
| Enumeration Date | 2017-03-13 |
| Last Update Date | 2022-09-02 |