| NPI | 1306311956 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 59055) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: OH 50.005725RX) |
| Enumeration Date | 2018-10-10 |
| Last Update Date | 2021-04-12 |