| NPI | 1669686077 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224900000X Mastectomy Fitter |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC 4979) |
| 225000000X Orthotic Fitter | |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2013-09-13 |