| NPI | 1265698658 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.005373RX) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WI 2324-023) |
| Enumeration Date | 2008-08-05 |
| Last Update Date | 2025-04-25 |