| NPI | 1477896942 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-05031) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.000758) |
| Enumeration Date | 2013-04-02 |
| Last Update Date | 2015-03-13 |