| NPI | 1538406491 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 2589) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.003693) |
| Enumeration Date | 2013-01-12 |
| Last Update Date | 2018-02-23 |