| NPI | 1629431002 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OH 50.004931RX) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NC 001006331) |
| Enumeration Date | 2016-04-01 |
| Last Update Date | 2019-10-24 |