| NPI | 1427779396 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: MI 4703111765) |
| Additional Taxonomies | 211D00000X Assistant, Podiatric (Licence: MI 4703111765) |
| Enumeration Date | 2022-09-08 |
| Last Update Date | 2022-09-08 |