| NPI | 1194726901 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 1418) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50-00-0523) |
| 363A00000X Physician Assistant (Licence: IN 10000174A) | |
| 363AS0400X Physician Assistant, Surgical (Licence: SC 1418) | |
| Enumeration Date | 2005-08-02 |
| Last Update Date | 2021-05-11 |