| NPI | 1558734681 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.006384RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY PA2952) |
| 363A00000X Physician Assistant (Licence: IN 10003578A) | |
| Enumeration Date | 2015-11-11 |
| Last Update Date | 2024-01-19 |