| NPI | 1629306022 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 002995) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA054059) |
| 363A00000X Physician Assistant (Licence: PA OA002403) | |
| Enumeration Date | 2009-11-23 |
| Last Update Date | 2014-03-17 |