| NPI | 1134677891 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.005199RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-06721) |
| Enumeration Date | 2016-09-12 |
| Last Update Date | 2017-10-17 |