| NPI | 1013452622 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA060474) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 363AS0400X Physician Assistant, Surgical (Licence: OH 50.005833RX) | |
| Enumeration Date | 2017-01-05 |
| Last Update Date | 2024-04-04 |