| NPI | 1487127973 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AR PA-988) |
| Additional Taxonomies | 2086S0120X Surgery Pediatric Surgery (Licence: FL 9111860) |
| 363A00000X Physician Assistant (Licence: OH 50.006311RX) | |
| 363A00000X Physician Assistant (Licence: FL PA9111860) | |
| Enumeration Date | 2019-01-07 |
| Last Update Date | 2021-09-01 |