| NPI | 1760591887 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.008893RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 000310) |
| 363AM0700X Physician Assistant, Medical | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2024-12-17 |