| NPI | 1871803676 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OH 50.002241) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TX PA03157) |
| 363A00000X Physician Assistant (Licence: TX 1052607 NCCPA number) | |
| Enumeration Date | 2010-10-14 |
| Last Update Date | 2020-11-18 |