| NPI | 1669496303 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OH 50.003492) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 001538) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2012-10-22 |