| NPI | 1609031822 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.007475RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA60578893) |
| 363AM0700X Physician Assistant, Medical (Licence: FL PA9104668) | |
| Enumeration Date | 2008-07-28 |
| Last Update Date | 2025-07-28 |