| NPI | 1689149692 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.008635RX) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 022723) |
| 363AM0700X Physician Assistant, Medical (Licence: FL PA9113200) | |
| Enumeration Date | 2018-10-05 |
| Last Update Date | 2024-11-01 |