| NPI | 1154519239 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.007105RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9112057) |
| Enumeration Date | 2007-10-14 |
| Last Update Date | 2022-09-21 |