| NPI | 1134525298 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10002430A) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: OH 50004211) |
| 363AM0700X Physician Assistant, Medical (Licence: PA MA057073) | |
| Enumeration Date | 2014-11-17 |
| Last Update Date | 2023-11-06 |