| NPI | 1023358751 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OH 50.004965RX) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL B640536866330) |
| Enumeration Date | 2013-02-16 |
| Last Update Date | 2019-06-13 |