| NPI | 1457778938 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 9634) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: OH 003551) |
| 363A00000X Physician Assistant (Licence: OH 50.0048272RX) | |
| Enumeration Date | 2014-03-24 |
| Last Update Date | 2023-06-20 |