| NPI | 1659918589 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 222Z00000X Orthotist (Licence: WA OI.60841234) |
| Additional Taxonomies | 224P00000X Prosthetist (Licence: WA PS.60990671) |
| Enumeration Date | 2019-12-10 |
| Last Update Date | 2019-12-10 |