| NPI | 1093183964 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA058938) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: OH 004439) |
| Enumeration Date | 2015-09-09 |
| Last Update Date | 2020-10-01 |