| NPI | 1780136689 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 9343) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.004844RX) |
| Enumeration Date | 2016-10-27 |
| Last Update Date | 2021-01-07 |