| NPI | 1194151654 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: OH 50,003852) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: OH 50.003852) |
| Enumeration Date | 2013-09-16 |
| Last Update Date | 2022-07-15 |