| NPI | 1740900612 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: TX 1602217) |
| Additional Taxonomies | 405300000X Prevention Professional (Licence: TX 1602217) |
| Enumeration Date | 2022-08-31 |
| Last Update Date | 2022-08-31 |