| NPI | 1285855510 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50000763) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: OH 50-000763) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2015-08-27 |