| NPI | 1013288166 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OH 50.005533RX) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363A00000X Physician Assistant (Licence: FL PA9106438) | |
| 363AM0700X Physician Assistant, Medical (Licence: FL PA9106438) | |
| Enumeration Date | 2012-01-21 |
| Last Update Date | 2020-11-18 |