| NPI | 1295796837 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: OH 50-002055) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50-002055) |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2010-02-04 |