| NPI | 1073164497 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 63882) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.006150RX) |
| Enumeration Date | 2019-09-26 |
| Last Update Date | 2024-06-27 |