| NPI | 1861725434 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.003076) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C04045) |
| 363A00000X Physician Assistant (Licence: MI 5601005960) | |
| Enumeration Date | 2009-09-14 |
| Last Update Date | 2016-01-08 |