| NPI | 1992275770 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1744P3200X Specialist, Prosthetics Case Management |
| Additional Taxonomies | 224900000X Mastectomy Fitter |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2018-12-05 |
| Last Update Date | 2018-12-05 |