| NPI | 1528002730 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: OH 50004039) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 003527) |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2014-06-10 |