| NPI | 1073757605 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: OH 50-001647) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA61471747) |
| Enumeration Date | 2009-04-27 |
| Last Update Date | 2023-10-18 |