| NPI | 1205220696 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 004309) |
| Additional Taxonomies | 208VP0000X (Licence: OH 50004309) |
| Enumeration Date | 2015-03-24 |
| Last Update Date | 2016-09-23 |