| NPI | 1417149675 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.002634) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: OH 50.002634) |
| 363AS0400X Physician Assistant, Surgical (Licence: IL 085003591) | |
| Enumeration Date | 2007-08-13 |
| Last Update Date | 2023-02-20 |