| NPI | 1386156503 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: GA 9189) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: OH 50.005234RX) |
| Enumeration Date | 2017-10-27 |
| Last Update Date | 2019-03-11 |