| NPI | 1275687246 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: OH 50.002017RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50-002017) |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2020-09-04 |