| NPI | 1407165244 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA057586) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: OH 50.003406) |
| Enumeration Date | 2010-09-28 |
| Last Update Date | 2015-06-24 |