| NPI | 1538488168 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 9973) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50-00-3049) |
| Enumeration Date | 2010-05-21 |
| Last Update Date | 2020-10-14 |