| NPI | 1205009842 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.005661RX) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: OH 50.005661RX) |
| 363AM0700X Physician Assistant, Medical (Licence: IN 99031537a) | |
| 363A00000X Physician Assistant (Licence: IN 10000993A) | |
| Enumeration Date | 2008-04-03 |
| Last Update Date | 2021-09-21 |