| NPI | 1134138522 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50002378RX) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: OH 2378) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2020-11-24 |