| NPI | 1366862096 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.008060) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA16204) |
| Enumeration Date | 2014-04-21 |
| Last Update Date | 2025-02-25 |