| NPI | 1376708420 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.003231) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA053462) |
| Enumeration Date | 2008-07-28 |
| Last Update Date | 2015-12-10 |