| NPI | 1275826463 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50004427) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 002164) |
| Enumeration Date | 2011-05-19 |
| Last Update Date | 2015-09-23 |