| NPI | 1437482312 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110004932) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.002938) |
| Enumeration Date | 2009-09-10 |
| Last Update Date | 2024-03-19 |