| NPI | 1740257369 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.002264RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WV 01118) |
| Enumeration Date | 2006-03-02 |
| Last Update Date | 2024-04-01 |