| NPI | 1467741470 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.005423RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-02838) |
| 363AM0700X Physician Assistant Medical (Licence: NC 001002838) | |
| 363AS0400X Physician Assistant Surgical (Licence: OH 50.005423RX) | |
| Enumeration Date | 2011-03-30 |
| Last Update Date | 2018-05-17 |