| NPI | 1225208267 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: ME P011527) |
| Additional Taxonomies | 1744P3200X Specialist, Prosthetics Case Management (Licence: ABC CERT CFM01831) |
| Enumeration Date | 2008-03-05 |
| Last Update Date | 2009-06-05 |