| NPI | 1497955215 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-10374) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 1750) |
| 363A00000X Physician Assistant (Licence: WV 01276) | |
| 363A00000X Physician Assistant (Licence: OH 50002428) | |
| Enumeration Date | 2007-07-19 |
| Last Update Date | 2023-07-12 |