| NPI | 1760948962 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: TX 1003125) |
| Additional Taxonomies | 1744P3200X Specialist, Prosthetics Case Management |
| Enumeration Date | 2019-02-13 |
| Last Update Date | 2022-12-06 |