| NPI | 1639774417 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 246ZX2200X Specialist/Technologist, Other, Orthopedic Assistant (Licence: 20-0710) | 
| Additional Taxonomies | 374700000X Technician | 
| Enumeration Date | 2020-12-01 | 
| Last Update Date | 2020-12-01 |