| NPI | 1699269415 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.007661) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DC PA031457) |
| 363A00000X Physician Assistant (Licence: NC 0010-08032) | |
| Enumeration Date | 2018-06-15 |
| Last Update Date | 2023-10-13 |