| NPI | 1558313775 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9108291) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN 0161260-22) |
| 363AM0700X Physician Assistant, Medical (Licence: NC 0010-0981) | |
| 363A00000X Physician Assistant (Licence: OH 50.002976) | |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2015-02-12 |