| NPI | 1679341036 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: MD 103977) |
| Additional Taxonomies | 174400000X Specialist (Licence: MD 103977) |
| 1744P3200X Specialist, Prosthetics Case Management (Licence: MD 103977) | |
| 335E00000X Prosthetic/Orthotic Supplier (Licence: MD 103977) | |
| Enumeration Date | 2023-12-15 |
| Last Update Date | 2024-03-12 |