| NPI | 1316983836 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA ma052114) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH OA001002) |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2017-02-14 |