| NPI | 1366841322 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110004574) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50004053) |
| Enumeration Date | 2014-08-15 |
| Last Update Date | 2022-01-07 |