| NPI | 1659606424 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: PA MA054066) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: OH 50.004461RX) |
| Enumeration Date | 2009-10-12 |
| Last Update Date | 2019-02-28 |