| NPI | 1750529806 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9105549) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: OH 50-001503) |
| Enumeration Date | 2009-01-28 |
| Last Update Date | 2012-10-10 |