| NPI | 1417911140 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.001961) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50001961) |
| Enumeration Date | 2006-04-12 |
| Last Update Date | 2011-10-18 |