| NPI | 1679749014 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.005136RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA055640) |
| 363A00000X Physician Assistant (Licence: FL PA9104163) | |
| Enumeration Date | 2008-05-06 |
| Last Update Date | 2022-06-15 |