| NPI | 1316929300 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OH 50.001480Rx) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: OH 50-00-1480) |
| Enumeration Date | 2005-11-16 |
| Last Update Date | 2022-10-03 |