| NPI | 1134199094 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OH 50.003927) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: UT 7140212-1206) |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2014-12-05 |