| NPI | 1598005753 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.005345RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601006617) |
| Enumeration Date | 2013-02-26 |
| Last Update Date | 2020-02-21 |