| NPI | 1326391509 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OH 50.005109RX) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MD C04907) |
| Enumeration Date | 2012-10-24 |
| Last Update Date | 2018-07-06 |