| NPI | 1053552919 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50003535) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-01772) |
| Enumeration Date | 2009-03-23 |
| Last Update Date | 2023-11-03 |