| NPI | 1801180211 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OH 50.004685RX) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: GA 6101) |
| Enumeration Date | 2011-06-02 |
| Last Update Date | 2018-06-26 |