| NPI | 1245515360 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.003393) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY TC061) |
| Enumeration Date | 2011-10-20 |
| Last Update Date | 2012-12-20 |