| NPI | 1982065652 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1744P3200X Specialist, Prosthetics Case Management (Licence: GA CO090464) |
| Additional Taxonomies | 224900000X Mastectomy Fitter (Licence: GA CO090464) |
| Enumeration Date | 2016-03-09 |
| Last Update Date | 2025-11-06 |