| NPI | 1548301203 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: OH 50003310) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NH 0624) |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2011-08-05 |