| NPI | 1790155893 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10002817A) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: OH 50.004441) |
| Enumeration Date | 2015-10-01 |
| Last Update Date | 2021-09-13 |