| NPI | 1003009176 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9105543) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.002263) |
| Enumeration Date | 2007-08-22 |
| Last Update Date | 2011-08-23 |