| NPI | 1346773157 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: MI 5901400357) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI S636478067249) |
| Enumeration Date | 2017-04-07 |
| Last Update Date | 2023-10-04 |