| NPI | 1972357796 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: TX p8wun1ja8r) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX p8wun1ja8r) |
| Enumeration Date | 2024-04-17 |
| Last Update Date | 2025-06-19 |