| NPI | 1144295510 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601002407) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: MI 5901001379) |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2025-01-29 |