| NPI | 1912204736 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 172M00000X Mechanotherapist (Licence: ME MT 4509) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: ME R039551) |
| Enumeration Date | 2011-02-14 |
| Last Update Date | 2011-02-14 |