| NPI | 1558306035 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 002939) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00322600) |
| Enumeration Date | 2006-06-18 |
| Last Update Date | 2018-03-21 |