| NPI | 1457639643 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OH 50.004524RX) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MI 5601009938) |
| 363AM0700X Physician Assistant, Medical (Licence: NY 014829) | |
| Enumeration Date | 2011-07-22 |
| Last Update Date | 2024-10-01 |