| NPI | 1720461809 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.005083RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 018743) |
| Enumeration Date | 2015-07-07 |
| Last Update Date | 2022-07-21 |