| NPI | 1366947533 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.005845RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601008591) |
| 363A00000X Physician Assistant (Licence: NY 025684) | |
| Enumeration Date | 2018-03-28 |
| Last Update Date | 2022-12-20 |