| NPI | 1548545544 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.003594) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA9106254) |
| Enumeration Date | 2011-10-21 |
| Last Update Date | 2013-11-22 |