| NPI | 1538116249 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-05465) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50002385) |
| Enumeration Date | 2006-05-28 |
| Last Update Date | 2025-05-01 |