| NPI | 1609818665 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OH 50.004712RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA051937) |
| 363A00000X Physician Assistant (Licence: MD C0005860) | |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2016-08-17 |