| NPI | 1245475714 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WV 01379) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: OH 50.002825) |
| Enumeration Date | 2008-12-11 |
| Last Update Date | 2024-07-02 |