| NPI | 1639391683 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.004010RX) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: OH 50.004010) |
| 207R00000X Internal Medicine (Licence: MA AP2134) | |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2021-11-04 |