| NPI | 1396254009 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.007774RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 3013) |
| 363A00000X Physician Assistant (Licence: VA 0110007485) | |
| 363AM0700X Physician Assistant, Medical (Licence: IN 10002314A) | |
| Enumeration Date | 2017-09-26 |
| Last Update Date | 2022-12-06 |