| NPI | 1942749783 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1744P3200X Specialist, Prosthetics Case Management (Licence: GA COL001713) |
| Additional Taxonomies | 174400000X Specialist (Licence: GA CO121589) |
| Enumeration Date | 2017-02-13 |
| Last Update Date | 2017-02-13 |