| NPI | 1679901995 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 1744P3200X Specialist, Prosthetics Case Management (Licence: GA 1744p3200x) |
| 335E00000X Prosthetic/Orthotic Supplier | |
| Enumeration Date | 2013-10-23 |
| Last Update Date | 2023-05-31 |