| NPI | 1699811356 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.005276RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 011593-1) |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2020-05-01 |