| NPI | 1447517396 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.003507RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 003507) |
| 363A00000X Physician Assistant (Licence: DE C5-0000813) | |
| Enumeration Date | 2012-04-17 |
| Last Update Date | 2019-01-22 |