| NPI | 1104888213 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.002042RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50002042) |
| Enumeration Date | 2006-04-04 |
| Last Update Date | 2020-08-25 |