| NPI | 1508444589 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601011082) |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2021-03-31 |
| Last Update Date | 2025-12-23 |