| NPI | 1801088372 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA PA58178) | 
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: OH 50-001339) | 
| Enumeration Date | 2007-08-17 | 
| Last Update Date | 2020-07-24 |