| NPI | 1760670954 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OH 2230) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH 50.002230) |
| Enumeration Date | 2007-10-12 |
| Last Update Date | 2008-11-12 |