| NPI | 1780490441 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 224P00000X Prosthetist (Licence: NC C100703) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: NC x58qcwvhhy) |
| Enumeration Date | 2024-12-07 |
| Last Update Date | 2025-02-04 |