| NPI | 1992275770 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 246RP1900X Technician, Pathology, Phlebotomy (Licence: TX M6G2E8J4) | 
| Additional Taxonomies | 1744P3200X Specialist, Prosthetics Case Management | 
| 224900000X Mastectomy Fitter | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2018-12-05 | 
| Last Update Date | 2024-10-24 |