| NPI | 1154656890 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OH 004399) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA PA20594) |
| Enumeration Date | 2009-10-14 |
| Last Update Date | 2018-10-26 |