| NPI | 1487193132 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.007959rx) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0006386) |
| 363A00000X Physician Assistant (Licence: FL PA9111155) | |
| 363AS0400X Physician Assistant, Surgical (Licence: TN 4542) | |
| Enumeration Date | 2017-02-14 |
| Last Update Date | 2023-03-20 |