| NPI | 1144852989 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care (Licence: MI 5601010158) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601010158) |
| Enumeration Date | 2020-02-10 |
| Last Update Date | 2023-08-16 |