| NPI | 1215262704 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.003502RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.003502) |
| Enumeration Date | 2009-10-16 |
| Last Update Date | 2016-04-07 |