| NPI | 1023255387 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.002806) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: OH 50.002806) |
| 363AM0700X Physician Assistant, Medical (Licence: OH 54.000538) | |
| 363A00000X Physician Assistant (Licence: OH 55.000538) | |
| Enumeration Date | 2009-01-08 |
| Last Update Date | 2015-06-18 |