| NPI | 1700283926 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: FL CL0239124) |
| Additional Taxonomies | 1744P3200X Specialist, Prosthetics Case Management (Licence: FL CL0239124) |
| 335E00000X Prosthetic/Orthotic Supplier (Licence: FL CL0239124) | |
| Enumeration Date | 2014-12-03 |
| Last Update Date | 2023-08-14 |