| NPI | 1689238669 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: AZ 9065) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.005865RX) |
| 363AS0400X Physician Assistant, Surgical | |
| Enumeration Date | 2019-04-25 |
| Last Update Date | 2024-10-17 |