| NPI | 1215306196 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA60477) | 
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 004407) | 
| Enumeration Date | 2015-09-21 | 
| Last Update Date | 2024-07-18 |