| NPI | 1639706195 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: MI 5951001370) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: MI 5951001370APP20) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-03-25 |
| Last Update Date | 2021-03-22 |