| NPI | 1538527395 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA062843) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601010940) |
| 363A00000X Physician Assistant (Licence: OH 50.005253RX) | |
| Enumeration Date | 2016-02-08 |
| Last Update Date | 2022-05-09 |