| NPI | 1861471773 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50003150) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA10004767) |
| 363A00000X Physician Assistant (Licence: FL PA9104538) | |
| Enumeration Date | 2006-01-10 |
| Last Update Date | 2015-06-26 |