| NPI | 1700190063 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 222Z00000X Orthotist (Licence: WA OI00000055) |
| Additional Taxonomies | 224P00000X Prosthetist (Licence: WA PS00000056) |
| Enumeration Date | 2010-07-28 |
| Last Update Date | 2022-05-13 |