| NPI | 1952031239 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: GA HD000468) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: GA HD000468) |
| Enumeration Date | 2022-06-10 |
| Last Update Date | 2022-06-10 |