| NPI | 1669893160 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OH 50.004398) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TN 2446) |
| Enumeration Date | 2013-12-30 |
| Last Update Date | 2018-11-26 |