| NPI | 1033461520 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: VA 0110004049) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: OH 003606) |
| Enumeration Date | 2012-10-08 |
| Last Update Date | 2023-08-17 |