| NPI | 1124109616 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.008362) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NM PA2018-0071) |
| 363A00000X Physician Assistant (Licence: NY 017793) | |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2025-01-13 |