| NPI | 1457681900 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.005061RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 57804) |
| Enumeration Date | 2010-01-06 |
| Last Update Date | 2025-09-14 |