| NPI | 1548500606 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.007514) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MA PA4644) |
| 363AS0400X Physician Assistant, Surgical (Licence: FL PA9107397) | |
| 363AS0400X Physician Assistant, Surgical (Licence: OH 50.007514) | |
| Enumeration Date | 2013-02-26 |
| Last Update Date | 2022-08-31 |