| NPI | 1841214665 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OH 50.003450) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NC 103585) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2012-04-20 |