| NPI | 1811001191 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10000484) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.007568RX) |
| 363A00000X Physician Assistant (Licence: NY 028525) | |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2024-01-11 |