| NPI | 1508340696 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OH 50.005713RX) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: KY PA2496) |
| 363AS0400X Physician Assistant, Surgical (Licence: KY PA2496) | |
| 363AS0400X Physician Assistant, Surgical (Licence: OH 50.005713RX) | |
| Enumeration Date | 2018-09-24 |
| Last Update Date | 2022-08-03 |