| NPI | 1871152769 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OH 50.006015) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MI 5601009779) |
| Enumeration Date | 2019-06-13 |
| Last Update Date | 2022-09-22 |