| NPI | 1528439767 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.009174rx) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA9109083) |
| Enumeration Date | 2015-10-14 |
| Last Update Date | 2024-12-11 |