| NPI | 1083914485 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.003135) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC TL1596) |
| Enumeration Date | 2010-11-01 |
| Last Update Date | 2013-05-14 |