| NPI | 1174034250 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10002341A) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.005275RX) |
| Enumeration Date | 2017-10-17 |
| Last Update Date | 2021-05-12 |