| NPI | 1508176751 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.008534RX) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MD C0008243) |
| 363AM0700X Physician Assistant, Medical (Licence: WA PA60196290) | |
| Enumeration Date | 2010-10-20 |
| Last Update Date | 2024-02-02 |