| NPI | 1871924571 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.004353) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA056400) |
| Enumeration Date | 2013-12-05 |
| Last Update Date | 2015-06-11 |