| NPI | 1891089215 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 222Z00000X (Licence: WA OI60177376) |
| Additional Taxonomies | 224P00000X Prosthetist (Licence: WA PS60177307) |
| Enumeration Date | 2011-06-02 |
| Last Update Date | 2011-06-02 |