| NPI | 1417124314 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-12492) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.002761) |
| Enumeration Date | 2008-05-11 |
| Last Update Date | 2025-09-16 |