| NPI | 1417351859 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WV 2374) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.004166) |
| Enumeration Date | 2014-10-14 |
| Last Update Date | 2022-01-25 |