| NPI | 1700908027 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 003813) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 001739) |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2015-02-04 |