| NPI | 1508062712 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.002330) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA052535) |
| Enumeration Date | 2007-06-25 |
| Last Update Date | 2009-04-03 |