| NPI | 1932285178 |
|---|---|
| Former Name | EDA SUSAN PEITHMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 224900000X Mastectomy Fitter |
| Additional Taxonomies | 225000000X Orthotic Fitter |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2020-02-24 |