| NPI | 1831196344 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224P00000X Prosthetist (Licence: NC CPO02762) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NC 103244) |
| 222Z00000X Orthotist (Licence: NC CPO02762) | |
| Enumeration Date | 2005-06-30 |
| Last Update Date | 2008-10-31 |