| NPI | 1043942766 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA61396582) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.007657RX) |
| Enumeration Date | 2022-06-30 |
| Last Update Date | 2024-09-27 |