| NPI | 1275540064 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50-002472) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10001135A) |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2019-08-27 |