| NPI | 1265848659 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.004499) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 99062710A) |
| Enumeration Date | 2014-07-07 |
| Last Update Date | 2015-10-20 |