| NPI | 1629959978 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 224L00000X Pedorthist (Licence: CA CPED3872) |
| Additional Taxonomies | 225000000X Orthotic Fitter (Licence: CA CFO05699) |
| Enumeration Date | 2025-09-11 |
| Last Update Date | 2025-09-11 |