| NPI | 1558782847 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OH 50.004857RX) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: VA 0110004801) |
| 363AM0700X Physician Assistant, Medical (Licence: CO PA.0003641) | |
| Enumeration Date | 2014-01-03 |
| Last Update Date | 2020-09-10 |