| NPI | 1063592632 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367H00000X Anesthesiologist Assistant (Licence: OH 67.000125) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: GA 1410) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2008-05-19 |