| NPI | 1649389412 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA055930) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50002475) |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2020-08-17 |