| NPI | 1215287289 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.003660RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085007062) |
| Enumeration Date | 2012-09-17 |
| Last Update Date | 2019-10-31 |