| NPI | 1508906116 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.003959) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD 1076380) |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2020-03-18 |