| NPI | 1578894713 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA2621) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.003015RX) |
| 207P00000X Emergency Medicine (Licence: OH 50.003015RX) | |
| Enumeration Date | 2010-01-28 |
| Last Update Date | 2021-06-09 |