| NPI | 1477551463 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: OH 50001432) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50-00-1432) |
| Enumeration Date | 2005-07-13 |
| Last Update Date | 2019-12-16 |