| NPI | 1114975323 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-01730) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50-000680) |
| 363A00000X Physician Assistant (Licence: OH 50.000680) | |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2011-02-25 |